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"Pada 28 kasus diabetes melitus ( DM ) tipe 2 tanpa kelainan kardiovaskular yang diperiksa di Bagian Metabolik Endokrin, Fakultas Kedokteran Universitas Indonesia/Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Jakarta, mulai Oktober 2001 sampai Desember 2001, dilakukan pemeriksaan ekokardiografi untuk melihat fungsi diastolik ventrikel kiri dan dilakukan pemeriksaan urin mikroalbuminuria. Disfungsi diastolik ditemukan pada 73,7 % pasien DM tipe 2 tanpa mikroalbuminuria dan 66,7% pada DM tipe 2 dengan mikroalbuminuria. Tidak terdapat hubungan bermakna kejadian disfungsi diastolik pada kelompok DM tipe 2 dengan mikroalbuminuria maupun DM tipe 2 tanpa mikroalbuminuria. (Med J Indones 2005; 14: 169-72)

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Twenty-eight cases of type 2 diabetes mellitus (DM) without any cardiovascular disease were recruited from the Department of Metabolic-Endocrine, Faculty of Medicine, University of Indonesia / Dr. Cipto Mangunkusumo General Hospital, Jakarta. Recruitment of the study began in October 2001 and was completed by December 2001. Participants were examined for echocardiography and microalbuminuria urinary examination. Diastolic dysfunction was found in 73.7% of type 2 diabetic patients without microalbuminuria and 66.7% in type 2 diabetic patients with microalbuminuria. Neither type 2 diabetic groups with nor without microalbuminuria indicated any significant association to the occurrence of diastolic dysfunction. (Med J Indones 2005; 14: 169-72)"

"Background: thyroid dysfunction is more likely to occur in diabetes mellitus patients than general population. Until now, no study has been done to find prevalence of hypothyroidism and hyperthyroidism in Indonesian diabetics. This study aimed to find the proportion and characteristics of thyroid dysfunction in Indonesian type 2 diabetes mellitus patients. Methods: a cross-sectional study was conducted in Endocrine and Diabetes Polyclinic, Department of Internal Medicine, Cipto Mangunkusumo Hospital from July to September 2015. This study include type 2 diabetes mellitus patients, age ≥ 18 year-old, willing to undergo thyroid laboratory testing. In this study, hypothyroidism defined as TSH more than 4.0 mIU/L, while hyperthyroidism is defined as TSH less than 0.4 mIU/L with eCLIA. Results: from 364 subjects who were recruited from Endocrine and Diabetes Polyclinic, Cipto Mangunkusumo Hospital, 303 subjects underwent this study until analysis. Two hundred and three (273) subjects (90.1%) were euthyroid, 7 subjects (2.31%) were hyperthyroid, and 23 subjects (7.59%) were hypothyroid. Majority of the patients had subclinical hypothyroidism (56.5% based on Zulewski and Billewicz Score and 65.2% based on fT4 laboratory result), while 42.9% and 71.4% subjects had clinical hyperthyroidism based on clinical appearance and fT4 laboratory result respectively. Conclusion: proportion of hypothyroidism was 7.59% and hyperthyroidism was 2.31%, while the proportion of total thyroid dysfunction was 9.9% among diabetics. It is suggested that screening for thyroid dyscfunction can be done in high risk condition as a part of comprehensive management in type 2 diabetes mellitus patients."

"ABSTRAKPrevalensi Diabetes Mellitus di Provinsi DKI Jakarta mengalami peningkatan danKepulauan Seribu menempati peringkat ke 3 tertinggi setelah Jakarta Selatan danJakarta Timur dengan proporsi 2,7% dengan jumlah kasus yang meningkat daritahun 2012 - 2015 di Kecamatan Kepulauan Seribu Utara. Penelitian ini bertujuanuntuk mengetahui hubungan antara faktor pengetahuan, riwayat diabetes mellituskeluarga, pola kebiasaan makan, aktivitas fisik dan perilaku merokok dengankejadian diabetes mellitus tipe 2 dan faktor mana yang paling dominan yangberhubungan dengan kejadian diabetes mellitus tipe 2. Penelitian dilaksanakan padabulan Februari 2016. Desain penelitian menggunakan case control dengan jumlahsampel penelitian sebanyak 80 kasus dan 80 kontrol. Hasil penelitian menunjukkanbahwa riwayat diabetes mellitus keluarga, faktor pengetahuan tentang diabetesmellitus, pola kebiasaan makan berisiko dan pola kebiasaan makan seratberhubungan signifikan dengan kejadian diabetes mellitus tipe 2. Hasil multivariatmenunjukkan bahwa penduduk dengan riwayat diabetes keluarga berisiko 6,2 kalilebih besar menderita diabetes mellitus dibandingkan dengan penduduk yang tidakmemiliki riwayat diabetes mellitus keluarga setelah dikontrol variabel pengetahuan,pola kebiasaan makan berisiko dan pola kebiasaan makan serat, aktifitas fisik, danperilaku merokok (95% CI: 2,810 ? 13,553). Dari penelitian ini disarankan untukmelakukan upaya preventif dan promotif yaitu dengan upaya perubahan perilakuuntuk menjadi lebih sehat dengan meningkatkan asupan serat, mengurangikebiasaan makan berisiko, dan meningkatkan pengetahuan tentang DM.

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ABSTRACTPrevalence of Diabetes Mellitus in Jakarta increased and prevalence in ThousandIslands District Administration was ranked the third highest after South Jakarta andEast Jakarta with a proportion of 2.7%. The number of cases increased from year2012 to 2015 in the SubDistrict of Kepulauan Seribu Utara. This study aims todetermine the relationship between knowledge, family history of diabetes mellitus,the pattern of eating habits, physical activity and smoking behavior with diabetesmellitus type 2 and the most dominant factors that associated with the occurrenceof diabetes mellitus type 2. The research was conducted in February 2016. Thestudy design using the case control study with a sample size of 80 cases and 80controls. Results showed that a family history of diabetes mellitus, diabetes mellitusknowledge, the pattern of risky eating habits and patterns of fiber eating habitssignificantly associated with diabetes mellitus type 2. Multivariate results showedthat the population with a family history of diabetes 6.2 times greater risk ofsuffering from diabetes mellitus compared with people who do not have a familyhistory of diabetes mellitus after controlled variable of knowledge, the pattern ofrisky eating habits and patterns of fiber eating habits (95% CI: 2.810 ? 13.553).From this research, it is advisable to carry out preventive and promotive efforts toattempt behavioral changes become healthier by increasing fiber intake, reducingthe risk of eating habits, and increase knowledge about diabetes."

"Latar Belakang. Terdapat dua hipotesis mengenai terjadinya diabetes melitus tipe 2 yaitu kegagalan sel beta pankreas dan resistensi insulin. Mengingat pengaruh faktor genetik pada kejadian DM tipe 2 maka diperkirakan resistensi insulin juga dipengaruhi faktor genetik. Sejauh ini data prevalensi resistensi insulin dan gambaran metabolik pads saudara kandung subyek DM tipe 2 di Indonesia belum ada.Tujuan. Mendapatkan angka prevalensi resistensi insulin pada saudara kandung subyek dengan DM tipe 2 dan mendapatkan data profil metabolik (profil lipid, IMT, lingkar perut, konsentrasi asam urat darah), tekanan darah dan distribusinya pads seluruh saudara kandung subyek dengan DM tipe 2Metodologi. Studi pendahuluan dan potong lintang dilakukan pada 30 saudara kandung subyek DM tipe 2 yang datang berobat di Poliklinik Metabolik dan Endokrinologi RSUPN Dr Cipto Mangunkusumo, untuk dilakukan wawancara, pemeriksaan fisik, konsentrasi insulin darah puasa, glukosa puasa, trigliserida, kolesterol HDL dan asam urat. Resistensi insulin ditentukan dari persentil 75 dari HOMA-IR.Hasil. Nilai cut-off HOMA-IR pada penelitian ini sebesar 2,04. Frekuensi resistensi insulin pads saudara kandung subyek DM sebesar 26,67% dengan proporsi di tiap keluarga bervariasi dari 0-75%. Semua subyek dengan resistensi insulin memiliki obesitas sentral dan sebanyak 75% memiliki IMT > 25. Komponen metabolik yang paling banyak ditemukan adalah obesitas sentral (56,7%), menyusul hipertensi (46,7%), hipokolesterol HDL dan hipertrigliseridemia masing-masing 26,6%, dan hiperglikemia (20%).Simpulan. Frekuensi resistensi insulin pada saudara kandung subyek DM tipe 2 sebesar 26,67% dengan proporsi yang bervariasi di setiap keluarga antara 0-75%. Komponen metabolik paling banyak ditemukan adalah obesitas sentral.

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Backgrounds. There are two hypothesis in the pathogenesis of type 2 DM, beta cell failure and insulin resistance. As genetic background has significant role in type 2 DM cases, insulin resistance is also suspected to be influenced by genetic factor. Thus far, there are no insulin resistance prevalence data and metabolic abnormalities among siblings of subjects with type 2 DM available in Indonesia.Objectives. To obtain prevalence figure of insulin resistance among siblings of subjects with type 2 DM and to obtain their metabolic abnormality profiles as measured by their BMI, waist circumference (WC), blood pressure, glucose intolerance, concentration of triglyceride, HDL cholesterol and uric acid.Methods. Cross-sectional study is conducted to 30 siblings of subjects with type 2 DM who are still alive and agree to participate in this study. The subjects are interviewed, physically examined and go through laboratory examination (fasting plasma insulin, plasma glucose, serum triglyceride, HDL cholesterol and uric acid concentration). Insulin resistance is derived from 75 percentile of HOMA-IR.Results. The HOMA-IR cut-off value found in this study is 2,04. The frequency of insulin resistance is 26,67% among siblings of subjects with type 2 DM within variation range of 0-75%. All of subjects with insulin resistance have central obesity. About 75% subjects with insulin resistance have BMI ? 25. The metabolic components which are frequently found in this study can be ranked as follows; central obesity (56,7%), hypertension (46,7%), hypocholesterol HDL (26,6%), hypertriglyceridemia (26,6%) and hyperglycemia (20%).Conclusion. The frequency of insulin resistance is 26,67% among siblings of subjects with type 2 DM within variation range of 0-75%. Among the metabolic components found in this study, central obesity is the most frequent."

"[ABSTRAKLatar belakang : Hiperglikemia kronik pada pasien Diabetes melitus tipe 1 (DMT1) dihubungkan dengan kerusakan jangka panjang, gangguan fungsi dan kerusakan berbagai organ tubuh lain seperti mata, ginjal, saraf, jantung dan pembuluh kapiler. Salah satu gangguan fungsi organ yang sering diabaikan sebagai akibat hiperglikemia adalah faal paru. Uji fungsi paru dapat membedakan kelainan paru obstruktif, restriktif atau campuran antara obstruktif dn restriktif. Uji fungsi paru dengan spirometri tidak dapat dilakukan dengan baik pada anak dibawah usia 7 atau 8 tahun karena memerlukan koordinasi yang cukup sulit. Penelitian tentang dampak DMT1 terhadap paru di Indonesia belum ada sampai saat ini.Tujuan : Mengetahui gambaran uji fungsi paru pada pasien DMT1 usia 8-18 tahun.Metode : Penelitian potong lintang dilakukan di Poliklinik Endokrinologi dan Respirologi Rumah Sakit Cipto Mangunkusumo (RSCM), serta Laboratorium Prodia Salemba pada bulan Januari 2015. Wawancara orangtua dilakukan dan data kadar HbA1c dalam rentang satu tahun terakhir diambil dari rekam medis subjek atau berdasarkan hasil pemeriksaan sebelumnya. Uji fungsi paru dilakukan sebanyak tiga kali dan diambil salah satu hasil yang terbaik. Kemudian subjek menjalani pengambilan darah untuk pemeriksaan kadar HbA1c dengan metode cation-exchange high pressure liquod chromatography (HPLC) di Laboratorium Prodia.Hasil : Tiga puluh lima subjek berpartisipasi dalam penelitian, terdiri dari 68,6% perempuan. Rerata usia 14 ± 2,7 tahun dan median durasi DM adalah 4 tahun (1,3-10,2 tahun). Rerata parameter FEV1 adalah 86,8 ± 14%, FVC 82,7 ± 12% dan V25 83,1 ± 26,2%. Median FEV1/FVC adalah 92,4 % (77,6-100) dan V50 91,5 % (41,1-204). Fungsi paru normal didapatkan pada 19 subjek (54,3%) dan fungsi paru terganggu sebanyak 16 subjek (45,7%), terdiri dari 10 subjek (28,6%) gangguan restriktif, 2 subjek (5,7%) gangguan obstruktif dan 4 subjek (11,4%) gangguan campuran. Rerata HbA1c dalam 1 tahun terakhir pada subjek dengan gangguan restriktif adalah 10,3%. Simpulan : Nilai parameter uji fungsi paru pasien DMT1 usia 8-18 tahun masih dalam batas normal. Gangguan fungsi paru didapatkan pada 16 subjek (45,7%) dengan gangguan restriksi terbanyak yaitu 10 subjek (28,6%).

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ABSTRACTBackground: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia.Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old.Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory.Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%.Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder.;Background: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia. Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old. Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory. Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%. Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder., Background: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia. Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old. Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory. Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%. Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder.]"

"ABSTRAKFaktor-Faktor Yang Berhubungan dengan Penerapan GayaHidup Sehat Diabetes Pada Penderita DM tipe 2 di KotaPematangsiantar Tahun 2017Penyakit Diabetes Mellitus DM menjadi salah satu masalah kesehatan yangbesar di dunia, termasuk di Indonesia. Prevalensi DM tipe 2 mengalamipeningkatan di Kota Pematangsiantar akibat dari perubahan gaya hidup. Tujuanpenelitian ini untuk menganalisis faktor-faktor yang berhubungan denganpenerapan gaya hidup sehat penderita DM tipe 2. Desain penelitian yangdigunakan adalah Cross Sectional, jumlah sampel 124 responden diambil denganmenggunakan Cluster Sampling. Analisis data menggunakan Uji Chi Square danregresi logistik ganda. Hasil penelitian menunjukkan ada hubungan antarapersepsi hambatan, efikasi diri, pengetahuan, dukungan keluarga, dan jeniskelamin dengan penerapan gaya hidup sehat DM Faktor-faktor yang palingdominan berhubungan dengan penerapan gaya hidup sehat adalah efikasi diri OR=8,378 dan dukungan keluarga OR=2,626 . Responden yang memilikiefikasi diri yang tinggi akan berpeluang 8 kali lebih besar melakukan penerapangaya hidup sehat, dan responden yang mendapat dukungan keluarga yang tinggiberpeluang 3 kali lebih besar melakukan penerapan gaya hidup sehat.Rekomendasi dari penelitian ini agar dilakukan upaya peningkatan efikasi diridengan pemberian edukasi pada penderita DM dengan melibatkan peran sertakeluarga penderita.Kata kunci : Diabetes melitus, Penerapan gaya hidup sehat, Persepsi Individu,Efikasi Diri, Pengetahuan, Dukungan Keluarga.

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ABSTRACTFactors Related to Application of Healthy Lifestyle of Type 2Diabetes Mellitus in Pematangsiantar 2017Diabetes Mellitus DM has become one of the major health problems inIndonesia as well as in many other countries. The prevalence of Type 2 DiabetesMellitus T2DM has increased in Pematangsiantar as result of lyfestyle change.This research aimed to analyze the factors related to application of healthylyfestyle of T2DM patient. This research rsquo s design used was Cross Sectional, thesample of 124 respondents was taken by Cluster Sampling. Data analysis usingChi Square Test and multiple logistic regression. The results show there is arelationship between perception of barriers, self efficacy, knowledge, familysupport, and gender with the application of healthy lifestyle. The most dominantfactors related to the application of healthy lifestyle are self efficacy OR 8,378 and family support OR 2,626 . Respondents who have high self efficacywill have 8 times greater chance of implementing a healthy lifestyle, andrespondents who have high family support have 3 times greater chance ofimplementing a healthy lifestyle. The recommendation of this research is to makeefforts to increase self efficacy by giving education to T2DM patient by involvingpatient 39 s family participation.Key Word T2DM application of healthy lifestyle Individual perceptions knowledge cues to action"

"ABSTRAKLatar belakang: Vitamin D dianggap berperan dalam patogenesis diabetes melitus tipe 1 (DMT1), memperbaiki kontrol metabolik dan menurunkan risiko terjadinya komplikasi mikrovaskuler.Tujuan: Mengetahui profil kadar vitamin D remaja DMT1 dan hubungan kadar vitamin D dengan retinopati dan nefropati diabetik.Metode: Penelitian potong lintang pada remaja DMT1 usia 11-21 tahun dengan lama sakit minimal satu tahun. Semua subjek dilakukan wawancara menggunakan kuesioner, pemeriksaan fisis lengkap, kadar 25(OH)D, HbA1c, rasio albumin/kreatinin urin, dan fotografi fundus.Hasil: Terdapat 49 subjek, 34 (69,4%) perempuan dan 15 (30,6%) lelaki dengan median lama sakit lima tahun (1-16 tahun). Sebanyak 96% subjek menggunakan insulin basal bolus. Median HbA1c adalah 9,5% (6,3% - 18%). Tidak ada subjek dengan kadar 25(OH)D ≥ 30 ng/mL, 6 subjek (12,2%) dengan kadar 25(OH)D 21-19 ng/mL dan 87,8% memiliki kadar 25(OH)D ≤ 20 ng/mL. Rerata kadar 25(OH)D adalah 12,6 ng/mL (SD ±5,4 ng/mL). Faktor yang berhubungan dengan kadar vitamin D adalah lama pajanan matahari (RP 13,3; 95%IK = 1,8-96, p= 0,019). Jenis pakaian, penggunaan sunblock, IMT, lama sakit, konsumsi susu tidak berhubungan dengan kadar vitamin D. Prevalens retinopati pada penelitian ini adalah 8,2%, mikroalbuminuria 28,5%, dan nefropati 16,3%. Tidak terdapat hubungan bermakna antara kadar vitamin D dengan retinopati, mikroalbuminuria, dan nefropati diabetik.Kesimpulan: Tidak ada remaja DMT1 dengan kadar vitamin D yang cukup dan tidak ada hubungan antara kadar vitamin D dengan retinopati, mikroalbuminuria, dan nefropati diabetik.;Background: Many studies showed that vitamin D involved in the pathogenesis of type 1 diabetes mellitus (T1DM), metabolic control and decreased the risk of microvascular complication.

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ABSTRACT

Objective: To find out the vitamin D profile in adolescence with T1DM and its association with retinopathy and nephropathy diabetic.

Methods: This was a cross sectional study performed during April to May 2015 involving T1DM adolescence aged 11-21 years old with duration of illness ≥ 1 year. We used questionnaire to know factors associated with vitamin D level. We performed physical examinations, tests for level of 25(OH)D serum, HbA1c, urine albumin/creatinine ratio and fundal photographic.

Results: There were 49 subjects, 34 female (69.4%) and 15 male (30.6%) with median duration of illness was five years (1-16 years). Most of the subjects (96%) were on basal bolus regimen. Median of HbA1c level was 9.5% (range 6.3%-18%). None of the subject had 25(OH)D level ≥ 30 ng/mL, 12.2% with 25(OH)D level of 21-19 ng/mL and 87,8% was ≤ 20 ng/mL. Mean of 25(OH)D level was 12.6 ng/mL (SD ±5.4 ng/mL). Duration of sun exposure was associated with 25(OH)D level (prevalent ratio of 13.3; 95%CI = 1.8-96, p= 0.019); While type of clothing, sunblock, body mass index, milk and juice intake were not associated with 25(OH)D level. Diabetic retinopathy was found in 4 subjects (8.2%), microalbuminuria in 14 subjects (28.5%), and nephropathy in 8 subjects (16.3%). All the subjects who suffered from microvascular complication had 25(OH)D level ≤ 20 ng/mL. None of the subjects with 25 (OH)D > 20 ng/mL suffered had microvascular complication. There was no significant association between vitamin D level with diabetic retinopathy, microalbuminuria, or diabetic nephropathy.

Conclusion: None of the adolescent with type 1 DM had sufficient vitamin D level, and 87.8% had vitamin D deficiency. There was no association between vitamin D level with diabetic retinopathy, microalbuminuria, or diabetic nephropathy."

"ABSTRAK Latar Belakang : Pasien diabetes melitus tipe 2 dengan penyakit arteri perifer (terutama critical limb ischemia) memiliki tingkat amputasi yang masih tinggi. Perkembangan teknik endovaskular memungkinkan tindakan revaskularisasi dengan tingkat keberhasilan yang tinggi dan komplikasi yang rendah dibandingkan operasi bypass.Tujuan : Penelitian ini bertujuan mengetahui tingkat keberhasilan klinis 1 tahun setelah tindakan Percutaneus Transluminal Angioplasty dan distribusi faktor-faktor yang mempengaruhi keberhasilan klinis.Metode : Penelitian ini merupakan studi kohort retrospektif pada pasien diabetes melitus tipe 2 dengan penyakit arteri perifer yang menjalani tindakan PTA pada tahun 2008-2012 di Pelayanan Jantung Terpadu Rumah Sakit Cipto Mangunkusumo Jakarta. Pasien diikuti selama 1 tahun setelah tindakan PTA. Luaran yang dinilai pada penelitian ini adalah keberhasilan klinis dan limb salvage. Definisi keberhasilan klinis adalah tidak mengalami amputasi mayor, tidak terjadi restenosis, dan tidak mengalami nyeri berulang. Sedangkan tingkat limb salvage adalah proporsi pasien dengan plantar stand yang utuh setelah tindakan PTA.Hasil : Tindakan PTA dilakukan pada 43 pasien dengan diabetes tipe 2. Manifestasi paling sering adalah gangren (30.2%) dan luka iskemik (30.2%). Sedangkan 8(18.2%) pasien datang dengan nyeri pada istirahat dan 9(20.2%) pasien datang dengan klaudikasio. Selama 1 tahun, 3 pasien mengalami amputasi mayor, 3 pasien mengalami restenosis, dan 4 pasien mengalami nyeri berulang. Keberhasilan klinis untuk 1 tahun adalah 75% dan tingkat limb salvage selama 1 tahun adalah 90%. Pasien dengan diabetes terkendali dan CTO memiliki proporsi keberhasilan klinis yang lebih tinggi.Simpulan : Tindakan PTA pada pasien diabetes melitus tipe 2 dengan PAD memiliki keberhasilan klinis dan tingkat limb salvage yang cukup baik.Kata Kunci : Angioplasti; diabetes; critical limb ischemia; penyakit arteri perifer; PTA; limb Salvage

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ABSTRACT Background : Diabetic patient with PAD (especially critical limb ischemia) still have a high rate of limb amputation. The development in endovascular technique allows revascularization with high level of success and low complication compare to surgical (bypass).Objectives :The aim of this study is to evaluate the clinical outcome 1 year after PTA in type 2 diabetic patient with PAD.Methods : This was a retrospective cohort study, with 1 year follow up, to evaluate the clinical outcome of diabetic patients with PAD that has undergone PTA procedure in 2008-2012 in Cipto Mangunkusumo Hospital. The main outcome measured were clinical success and limb salvage rate. Clinical success defined as no major amputation, no restenosis, and no reccurence pain after PTA. Limb salvage rate defined as proportion of patient with intact plantar stand after PTA.Results : PTA was performed in 43 patient with diabetes. In this study most frequent manifestation were gangren (30.2%) and ischemic wounds (30.2%), while 8 patients (18.2%) came with resting pain, and 9 patients (20.2%) have claudication. During one year follow up 3 patients (6.9%) had major amputation, 3 patients (6.9%) had restenosis, and 4 patients had resting pain reccurence. The clinical succes rate for one year is 75%, with limb salvage rate for 1 year is 90%. Patients with controlled diabetes and chronic total occlusion had a higher proportion of clinical success.Conclusion : PTA procedure for diabetic patient with PAD has good clinical outcome with high level of limb salvage rate.Keyword : Angioplasty; critical limb ischemia; diabetes; peripheral arterial disease; PTA; limb salvage"

"Diabetes mellitus (DM) adalah suatu keadaan dimana ditemukan peninggian kadar gula darah kronik yang dapat menimbulkan komplikasi akut dan kronik. Perawatan DM harus meliputi aspek emosional, sosial, perilaku, spiritual dan psikologis serta perubahan fisik dengan menerapkan lima pilar manajemen DM yakni kontrol gula darah, diit, latihan, pengobatan, dan pendidikan kesehatan yang dapat membantu meningkatkan kemampuan pasien dalam perawatan diri dan mencegah komplikasi.Penelitian ini bertujuan untuk menganalisis hubungan kesadaran diri pasien dengan kejadian komplikasi DM di RSUD dr. Adnan W.D Payakumbuh Sumbar. Penelitian ini menggunakan desain Cross Sectional Study. Jumlah sampel pada penelitian ini adalah 69 responden yang terdiri dari pasien rawat inap dan pasien rawat jalan bagian penyakit dalam di RSUD dr. Adnan W.D Payakumbuh. Tehnik pengambilan sampel yang digunakan adalah consecutive sampling.Hasil penelitian menunjukkan kesadaran diri berhubungan dengan kejadian komplikasi DM (p=0,000). Pasien dengan kesadaran diri kurang berisiko 20 kali untuk terjadi komplikasi dibanding pasien dengan kesadaran diri baik setelah dikontrol variabel usia, jenis kelamin, tipe DM, pendidikan, pekerjaan, dan penyuluhan. Diperoleh juga ada hubungan antara penyuluhan dengan kejadian komplikasi DM (p=0,027). Pasien yang tidak mendapatkan penyuluhan berisiko 9 kali untuk terjadi komplikasi dibanding dengan pasien yang pernah mendapat penyuluhan. Faktor konfonding hubungan kesadaran diri dengan kejadian komplikasi DM pada penelitian ini adalah usia, jenis kelamin, tipe DM, tingkat pendidikan, pekerjaan dan penyuluhan. Penelitian ini merekomendasikan perlunya meningkatkan kesadaran diri pasien sebagai salah satu intervensi mandiri perawat dalam mencegah komplikasi DM dan perlu penelitian lebih lanjut terkait strategi yang efektif dalam meningkatkan kesadaran diri pasien DM dengan komplikasi.

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Diabetes mellitus (DM) is a condition manifested by chronic high level of blood sugar that resulting in acute and chronic complications. Nursing care of DM must be concern to emotional, social, behavior, spiritual, psychological, and physical problem by applying five keys of DM management which consists of blood sugar control, diet, exercises, insulin treatment, and health education. These can help to increase patient?s self care and prevent from complications.The purpose of this study was to analyse the relation between self awareness and DM complications at Adnan Hospital Payakumbuh West Sumatera. A design cross sectional study was used in this research. The total samples were 69 DM patients who selected from outpatient and inpatient of Medical Unit Adnan Hospital. The sample was selected by a consecutive sampling method.The result showed that self awareness was correlated to DM complications (p=0,000). The patients which low self awareness have risk 20 times to complications after controlled by age, gender, DM type, level of education, occupation, and health education. Health education was correlated to DM complications too (p=0,027). The patients who never got health education have risk 9 times to complications after controlled by other variables. Confounding factors of correlated self awareness to DM complications in this study were age, gender, type of DM, level of patient education, occupation, and health education. This study recommended on the needs to improve patient self awareness as one of the independent nursing interventions and need future research about the effective strategy to increase patient self awareness with diabetes complications."