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"Diabetes Melitus tipe 2 merupakan penyebab kematian ke-2 pada kelompok usia 45-54 tahun di daerah perkotaan, sedangkan di pedesaan menduduki peringkat ke-6. Angka kejadiannya berhubungan dengan adanya resistensi insulin akibat berbagai macam faktor. Pola paling umum dijumpai adalah dislipidemia terutama hipertrigliseridemia dan pengurangan kadar HDL. Penelitian ini dirancang untuk melihat gambaran kadar trigliserida pada pasien DM tipe 2 yang berobat ke Poli IPD RSCM pada tahun 2010. Didapatkan bahwa dari 108 subyek, 55 orang berusia ≥55 tahun, 68 orang berjenis kelamin perempuan, 71 orang tidak merokok, dan 84 orang dengan kadar trigliserida normal. Dari hasil analisis didapat hubungan tidak bermakna antara kadar trigliserida dengan usia (Mann-Whitney, p = 0.104), jenis kelamin (Chi-square, p = 0.062), perilaku merokok (Chi-square, p = 0,973), kadar gula darah puasa (Mann-Whitney, p = 0.973), dan kadar gula darah dua jam post prandial. (Mann-Whitney, p = 0.539). Rerata TG berdasarkan analisis data adalah 140,5 (49-1144) mg/dL. Nilai rerata kadar glukosa darah puasa (GDP) 186,5 (114-559) mg/dL. Analisis data menunjukkan sebaran tidak normal dengan rerata kadar gula darah dua jam post prandial (GD2PP) sebesar 291 (178-582) mg/dL.

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Type 2 diabetic melitus is the second death cause on urban residencies age ranged 45-54 year old, while it is the 6th leading death cause on rural area, based on RISKEDA 2007. High rate of prevalencies is because insulin resistancies as results of multifactorial. Most common patern is dislipidemia especially hypertriglyceride and low level of HDL. This researh is designed to picture triglyceride level on type 2 diabetic melitus patients in RSCM on year 2010. Known that from 108 subjects, 55 are aged ≥55 year old, 68 are women, 71 don’t smoke and 84 with normal level of triglyceride. From analitic processes, known that triglyceride level is not associated with age (Mann-hitney, p = 0.104), sex (Chi-square, p = 0.062), smoking habbit (Chi-square, p = 0,973), fasting blood glucose (Mann-Whitney, p = 0.973), and 2 hours post-prandial blood glucose (Mann-Whitney, p = 0.539). Mean rate of triglyceride level is 140,5 (49-1144) mg/dL. Mean rate fasting blood glucose is 186,5 (114-559) mg/dL. Data analysis doesn’t show normal distribution on mean rate of level 2 hours post prandial blood glucose 291 (178-582) mg/dL."

"Diabetes Mellitus merupakan penyakit kronik. Penyakit diabetes mellitus ini diduga akan meningkat jumlahnya di masa datang. Berdasarkan penelitian, dikatakan bahwa diabetes mellitus tipe 2 dapat menyebabkan dislipidemia, yaitu hipertrigliseridemia, kadar HDL yang rendah serta peningkatan kadar sLDL. Meskipun mekanisme pastinya belum dipahami sepenuhnya, diduga bahwa resistensi insulin menyebabkan peningkatan asam lemak bebas dari adiposit sehingga terjadi peningkatan sintesis VLDL dan trigliserida yang akhirnya dapat menyebabkan dislipidemia. Penelitian ini dirancang untuk meneliti gambaran kadar HDL pada pasien diabetes mellitus tipe 2 di poliklinik IPD RSCM tahun 2010. Data dari 108 orang yang diambil secara simple random sampling dan random diperoleh dari data sekunder di Poliklinik IPD RSCM. Hasilnya adalah nilai rerata kadar gula darah puasa adalah 186,5 (114-559) mg/dL, sedangkan rerata kadar gula darah 2PP adalah 291(178-582) mg/dL. Dengan uji Mann-Whitney, didapatkan berturut-turut nilai p=0,383 dan p=0,208. Dengan demikian, dapat disimpulkan tidak terdapat perbedaan bermakna kadar gula darah puasa dan kadar gula darah 2PP dengan kadar HDL.

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Diabetes mellitus is a chronic disease. This diabetes mellitus disease is expected to increase in the future. According to studies, diabetes mellitus type 2 can cause dyslipidemia, which include hypertriglyceridemia, low HDL level, and high sLDL level. Although the exact mechanism has not yet fully understood, it is suspected that insulin resistance can cause an increase in free fatty acid level from adipocytes which end up in increased synthesis of VLDL and triglyceride and eventually dyslipidemia develops. This study is designed to study HDL profile in patients with diabetes mellitus type 2 in RSCM Internal Medicine polyclinic in 2010. Results from 108 patients taken with simple random sampling were obtained from secondary data in RSCM Internal Medicine Polyclinic. The average value of fasting blood glucose was 186,5 (114-559) mg/dL, while the average value of 2PP blood glucose was 291 (178-582) mg/dL. With Mann Whitney test, p value of fasting blood glucose and HDL level was 0,383 and p value of 2PP blood glucose and HDL level was 0,208. Therefore, it can be concluded that there is no significant difference between fasting blood glucose and 2PP blood glucose with HDL level."

"Latar Belakang: Prevalensi Diabetes Melitus (DM) tipe 2 cenderung meningkat di seluruh dunia dan keteraturan pengobatan masih menjadi masalah hingga saat ini. Penelitian terdahulu menemukan bahwa terdapat hubungan antara temperamen dengan kontrol glukosa namun belum banyak penelitian yang membahas hal ini. Penelitian ini bertujuan mengetahui hubungan antara temperamen dengan terkontrol atau tidak terkontrolnya DM tipe 2.Metode: Penelitian ini adalah penelitian analitik potong lintang. Pengambilan sampel dilakukan dengan consecutive sampling pada 110 penyandang DM tipe 2 di Poliklinik Metabolik Endokrin RSCM selama bulan Agustus-Desember 2015. Responden dikelompokkan menjadi penyandang DM terkontrol atau DM tidak terkontrol berdasarkan hasil laboratorium HbA1c terakhir. Responden mengisi kuesioner Modified-Temperament and Character Inventory versi bahasa Indonesia.Hasil: Hasil penelitian ini menunjukkan bahwa skor temperamen harm avoidance, novelty seeking, dan reward dependence tidak berhubungan bermakna dengan terkontrol atau tidak terkontrolnya DM tipe 2.Simpulan: Tidak ada hubungan bermakna antara temperamen dengan pengendalian kadar HbA1c pada penyandang DM tipe 2.

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Background: Prevalence on type 2 Diabetes Mellitus (DM) tend to increase across the world and regulating treatment still being one of the matters to be discussed until recently. Previous research had found that there are correlations between temperament with glucose control but with limited study on that area. This research aim to qualify the relationship between temperament to controllable or uncontrollable type 2 DM.

Method: This research is a cross sectional sampling method. Sampling conducted with consecutive sampling on 110 respondents with type 2 DM in RSCM Metabolism Endocrine Polyclinic, sampling was done between August to December 2015. Respondents are grouped to two different groups which is controllable DM and uncontrollable DM based on last HbA1c laboratory results. Respondents were requested to fill up Modified-Temperament and Character Inventory questionnaire in Bahasa Indonesia.

Results: Result on this research indicates that temperament score in harm avoidance, novelty seeking, and reward dependence are unrelated with whether Type 2 DM being controllable or uncontrollable.

Conclusion: Absent of significant relation between temperament and HbA1c level control in type 2 DM patients."

"ABSTRAKDiabetes melitus (DM) merupakan suatu kelompok penyakit metabolik dengan karakteristik hiperglikemia karena kelainan sekresi insulin, kerja insulin, atau keduanya. Selain terjadi gangguan metabolisme gula, pasien DM juga mengalami gangguan metabolisme lipid, disertai kenaikan berat badan sampai terjadinya obesitas, dan gejala hipertensi. Kadar kolesterol total yang tinggi (>240 mg/dL) pada pasien DM tipe 2 menaikkan risiko penyakit koroner. Penelitian ini menggunakan survai cross-sectional analitik untuk mendapatkan hubungan nilai kolesterol total dengan DM tipe 2, pada pasien DM tipe 2 yang berobat di poliklinik IPD RSUPN Cipto Mangunkusumo tahun 2010. Hasilnya yaitu hanya 13,9% subyek yang berusia di atas 54 tahun dan memiliki nilai kolesterol tinggi, dan hanya 12% subyek yang perokok dan memiliki nilai kolesterol tinggi. Pada kelompok kolesterol total tinggi, proporsi wanita 17,6% sementara pria 11,1%. Rerata gula darah puasa pada kelompok kolesterol tidak tinggi dan yang tinggi yaitu 189,0 (114-411) dan 185,0 (130-559). Rerata gula darah 2 jam post-prandial pada kelompok koresterol tidak tinggi dan yang tinggi yaitu 290,0 (178-582), dan 306,6 (SD 78,9).

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AbstractDiabetes mellitus (DM) is a group of metabolic diseases with characteristic hyperglycemia due to abnormalities in insulin secretion, insulin action, or both. In addition to disruption of sugar metabolism, diabetic patients also experience impaired lipid metabolism, accompanied by weight gain until the occurrence of obesity, and hypertension symptoms. High total cholesterol levels (> 240 mg/dL) in patients with type 2 diabetes increase the risk of coronary disease. This study used cross-sectional analytic survey to get a total cholesterol value the relationship with type 2 diabetes, in patients type 2 diabetes who seek treatment at polyclinics IPD Cipto Mangunkusumo in 2010. The result is only 13.9% of subjects over the age of 54 years and have high cholesterol values, and only 12% of subjects who smoked and had high cholesterol values. In the group of high total cholesterol, the proportion of women 17.6% while in men 11.1%.The mean fasting blood sugar of?not high cholesterol group? and ?high cholesterol group? is 189.0 (114-411) and 185.0 (130-559). The mean blood glucose 2 hours post-prandial of ?not high cholesterol group? and ?high cholesterol group? is 290.0 (178-582) and 306.6 (SD 78.9)."

"Latar Belakang: Peningkatan kadar high sensitivity C-reactive protein ( hsCRP ) dan kekakuan arteri berhubungan dengan peningkatan insiden kejadian kardiovaskular dan peningkatan mortalitas akibat penyakit jantung koroner pada pasien diabetes melitus tipe 2.Tujuan: Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara kadar hsCRP dan kekakuan arteri pada pasien diabetes melitus tipe 2.Metode : Melalui studi cross-sectional, dilakukan pemeriksaan kadar hsCRP dan derajat kekakuan arteri karotis pada 40 pasien dengan diabetes melitus tipe 2. Kekakuan arteri karotis kommunis diperiksa dengan doppler echotracking system untuk menentukan pulse wave velocity (PWV) atau kekakuan arteri karotis lokal (carotid-PWV).Hasil : Nilai median hsCRP pada penelitian ini adalah 4,5 (0,2 - 18,9) mg/L dan nilai rata-rata kekakuan arteri karotis adalah 8,8 ±1,7 m/detik. hsCRP berkorelasi kuat dengan karotid-PWV (r = 0,503, P = 0,001). Korelasi hsCRP dengan karotid-PWV ini tetap terlihat setelah dilakukan koreksi terhadap umur, indeks masa tubuh dan mean arterial pressure (r = 0,450, P = 0,005).Kesimpulan : Setelah dilakukan koreksi terhadap umur, indeks masa tubuh dan mean arterial pressure, hsCRP berkorelasi positif cukup kuat dengan kekakuan arteri pada pasien diabetes melitus tipe 2.

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Background: The elevated level of high-sensitivity C-reactive protein (hsCRP) and arterial stiffness are associated with higher incidences of cardiovascular events and with increased mortality from coronary heart disease in type 2 diabetic patients.

Aim: The aim of this study was to investigate the relationship between hsCRP and arterial stiffness in type 2 diabetic patients.

Methods: A cross-sectional study was conducted to assess the plasma levels of high sensitive C-reactive protein and carotid arterial stiffness among 40 patients with type 2 diabetes mellitus. The common carotid artery was studied by a doppler echotracking system to determine the local carotid pulse wave velocity (carotid-PWV).

Results: The median value of hsCRP in this study was 4.5 (0.2 to 18.9) mg/L and the average value of local carotid stiffness was 8.8 ± 1.7 m/sec. hsCRP showed a strong correlation with carotid-PWV (r = 0.503, P = 0.001). Levels of hsCRP were independently associated with carotid-PWV after adjusting for age, body mass index, and mean arterial pressure (r = 0,450, P = 0,005).

Conclusion: After adjusting for age, body mass index, and mean arterial pressure, hsCRP was strongly positively correlated with arterial stiffness in patients with type 2 diabets mellitus."

"ABSTRAK Latar Belakang. Prevalensi disfungsi tiroid lebih tinggi pada pasien diabetes dibandingkan populasiumum. Hipotiroidisme memperburuk komplikasi, morbiditas, mortalitas, dan kualitas hidup pasiendiabetes melitus tipe 2 (DM tipe 2). Faktor risiko hipotiroidisme pada pasien DM tipe 2 selama ini masihkontradiktif dan belum dikaji secara lengkap. Keberadaan sistem skor hipotiroidisme pada pasien DMtipe 2 diperlukan untuk membantu diagnosis dan menapis pasien DM tipe 2 yang memerlukanpemeriksaan laboratorium fungsi tiroid sebagai baku emas diagnosis hipotiroidisme.Tujuan. Mengetahui prevalensi dan determinan hipotiroidisme pada pasien DM tipe 2.Metode. Penelitian dengan desain potong lintang dilakukan di Poliklinik Divisi Metabolik Endokrin(Poliklinik Diabetes) RSCM pada Juli sampai September 2015 dengan metode sampling konsekutif.Subjek menjalani anamnesis, pemeriksaan fisis, dan pemeriksaan laboratorium (TSH dan fT4). Analisisdata dilakukan dengan program statistik SPSS Statistics 17.0 untuk analisis univariat, bivariat,multivariat, dan Receiving Characteristics Operator (ROC) dan SPSS Statistics 20.0 untuk analisisbootstrapping pada Kalibrasi Hosmer-Lemeshow.Hasil. Sebanyak 303 subjek dianalisis untuk mendapatkan proporsi disfungsi tiroid dan 299 subjekdianalisis untuk mendapatkan determinan hipotiroidisme. Sebanyak 23 subjek (7,59%) terdiagnosishipotiroidisme, terdiri dari 43,5% subjek hipotiroid klinis dan 56,5% subjek hipotiroid subklinisberdasarkan Indeks Zulewski dan/atau Indeks Billewicz, dengan 16,7% hipotiroid klinis dan 83,3%hipotiroid subklinis berdasarkan hasil pemeriksaan fT4. Determinan hipotiroidisme pada pasien DMtipe 2 adalah riwayat penyakit tiroid di keluarga dengan OR sebesar 4,719 (95% IntervalKepercayaan/IK 1,07-20,8, p = 0,04), keberadaan goiter dengan OR sebesar 20,679 (95% IK 3,49122,66, p = 0,001),kontrol glikemik yang buruk dengan OR sebesar 3,460 (95%IK 1,075-11,14, p = 0,037), dan adanya sindrom metabolikOR sebesar 25,718 (95% IK 2,21-299,99, p = 0,01). Simpulan. Proporsi hipotiroidisme pada pasien DM tipe 2 adalah 7,59%. Determinan diagnosis dan komponen sistem skor hipotiroidisme pada pasien DM tipe 2 adalah riwayat penyakit tiroid di keluarga, keberadaan goiter, kontrol glikemik yang buruk, dan adanya sindrom metabolik. Sistem skor yang diberi nama Skor Hipotiroid RSCM ini diharapkan menjadi alat bantu diagnosis hipotiroidisme pada pasienDM tipe 2. ABSTRACT Background. Prevalence of thyroid dysfunction is greater in diabetes patients compared to generalpopulation. Hypothyroidism is worsening complications, morbidity, mortality, and quality of life in type2 diabetes mellitus (T2DM) patients. Risk factors of hypothyroidism in T2DM patients are stillcontradictive and not assessed completely. Presence of scoring system to estimate hypothyroidism inT2DM patients are needed to help diagnosing and screening of T2DM patients who need to undergothyroid function test as a gold standard diagnostic for hypothyroidism.Aim. To identify prevalence and estimators of hypothyroidism in T2DM patients.Methods. A cross-sectional study was conducted in Metabolic Endocrine (Diabetes) Outpatient ClinicCipto Mangunkusumo Hospital from July-September 2015 with consecutive sampling method. Allsubjects underwent interview, physical examination, and laboratory testing (TSH and fT4). Analysiswas done by using SPSS Statistics 17.0 for univariate, bivariate, multivariate, and ROC (ReceivingOperator Characteristics) analysis and SPSS Statistics 20.0 for bootstrapping analysis in HosmerLemeshowCalibration. Results. 303 subjects included for proportion study of thyroid dysfunction and 299subjects included for analysis of hypothyroidism determinants. 23 subjects (7,59%) are diagnosed as havinghypothyroidism, consisted of 43,5% clinical hypothyroidism and 56,5% subclinical hypothyroidismbased on clinical scoring index by Zulewski and Billewicz, and 16,7% subjects as having clinicalhypothyroidism and 83,3% subjects as having subclinical hypothyroidism based on fT4 examination.Determinants for hypothyroidism in T2DM patients are family history of thyroid disease with OR 4,719(95% Confident Interval/CI 1,07-20,8, p = 0,04), having goiter or difus struma with OR 20,679 (95%CI 3,49-122,66, p = 0,001), poor glycemic control with OR 3,460 (95% CI 1,075-11,14, p = 0,037), and metabolic syndrome with OR 25,718 (95% CI 2,21-299,99, p = 0,01). Conclusion. Proportion of hypothyroidism in T2DM patients is 7,59%. Determinants and componentsof scoring system of hypothyroidism in T2DM patients consist of family history of thyroid disease,having goiter or difus struma, poor glycemic control, and metabolic syndrome. Scoring system which iscalled RSCM Hypothyroid Score is expected to be a tool for helping diagnosis of hypothyroidism inT2DM patients.;Background. Prevalence of thyroid dysfunction is greater in diabetes patients compared to generalpopulation. Hypothyroidism is worsening complications, morbidity, mortality, and quality of life in type2 diabetes mellitus (T2DM) patients. Risk factors of hypothyroidism in T2DM patients are stillcontradictive and not assessed completely. Presence of scoring system to estimate hypothyroidism inT2DM patients are needed to help diagnosing and screening of T2DM patients who need to undergothyroid function test as a gold standard diagnostic for hypothyroidism.Aim. To identify prevalence and estimators of hypothyroidism in T2DM patients.Methods. A cross-sectional study was conducted in Metabolic Endocrine (Diabetes) Outpatient ClinicCipto Mangunkusumo Hospital from July-September 2015 with consecutive sampling method. Allsubjects underwent interview, physical examination, and laboratory testing (TSH and fT4). Analysiswas done by using SPSS Statistics 17.0 for univariate, bivariate, multivariate, and ROC (ReceivingOperator Characteristics) analysis and SPSS Statistics 20.0 for bootstrapping analysis in HosmerLemeshowCalibration. Results.303subjectsincludedforproportionstudyofthyroiddysfunctionand299subjectsincludedforanalysis of hypothyroidism determinants. 23 subjects (7,59%) are diagnosed as havinghypothyroidism, consisted of 43,5% clinical hypothyroidism and 56,5% subclinical hypothyroidismbased on clinical scoring index by Zulewski and Billewicz, and 16,7% subjects as having clinicalhypothyroidism and 83,3% subjects as having subclinical hypothyroidism based on fT4 examination.Determinants for hypothyroidism in T2DM patients are family history of thyroid disease with OR 4,719(95% Confident Interval/CI 1,07-20,8, p = 0,04), having goiter or difus struma with OR 20,679 (95%CI 3,49-122,66, p = 0,001), poor glycemic control with OR 3,460 (95% CI 1,075-11,14, p = 0,037), and metabolic syndrome with OR 25,718 (95% CI 2,21-299,99, p = 0,01).Conclusion. Proportion of hypothyroidism in T2DM patients is 7,59%. Determinants and componentsof scoring system of hypothyroidism in T2DM patients consist of family history of thyroid disease,having goiter or difus struma, poor glycemic control, and metabolic syndrome. Scoring system which iscalled RSCM Hypothyroid Score is expected to be a tool for helping diagnosis of hypothyroidism inT2DM patients.;Background. Prevalence of thyroid dysfunction is greater in diabetes patients compared to generalpopulation. Hypothyroidism is worsening complications, morbidity, mortality, and quality of life in type2 diabetes mellitus (T2DM) patients. Risk factors of hypothyroidism in T2DM patients are stillcontradictive and not assessed completely. Presence of scoring system to estimate hypothyroidism inT2DM patients are needed to help diagnosing and screening of T2DM patients who need to undergothyroid function test as a gold standard diagnostic for hypothyroidism.Aim. To identify prevalence and estimators of hypothyroidism in T2DM patients.Methods. A cross-sectional study was conducted in Metabolic Endocrine (Diabetes) Outpatient ClinicCipto Mangunkusumo Hospital from July-September 2015 with consecutive sampling method. Allsubjects underwent interview, physical examination, and laboratory testing (TSH and fT4). Analysiswas done by using SPSS Statistics 17.0 for univariate, bivariate, multivariate, and ROC (ReceivingOperator Characteristics) analysis and SPSS Statistics 20.0 for bootstrapping analysis in HosmerLemeshowCalibration. Results.303subjectsincludedforproportionstudyofthyroiddysfunctionand299subjectsincludedforanalysis of hypothyroidism determinants. 23 subjects (7,59%) are diagnosed as havinghypothyroidism, consisted of 43,5% clinical hypothyroidism and 56,5% subclinical hypothyroidismbased on clinical scoring index by Zulewski and Billewicz, and 16,7% subjects as having clinicalhypothyroidism and 83,3% subjects as having subclinical hypothyroidism based on fT4 examination.Determinants for hypothyroidism in T2DM patients are family history of thyroid disease with OR 4,719(95% Confident Interval/CI 1,07-20,8, p = 0,04), having goiter or difus struma with OR 20,679 (95%CI 3,49-122,66, p = 0,001), poor glycemic control with OR 3,460 (95% CI 1,075-11,14, p = 0,037), and metabolic syndrome with OR 25,718 (95% CI 2,21-299,99, p = 0,01).Conclusion. Proportion of hypothyroidism in T2DM patients is 7,59%. Determinants and componentsof scoring system of hypothyroidism in T2DM patients consist of family history of thyroid disease,having goiter or difus struma, poor glycemic control, and metabolic syndrome. Scoring system which iscalled RSCM Hypothyroid Score is expected to be a tool for helping diagnosis of hypothyroidism inT2DM patients."

"Diabetes melitus dan gizi kurang secara terpisah dikatakan dapat meningkatkan kejadian tuberkulosis. Studi potong lintang analitik ini bertujuan untuk mengetahui adanya hubungan antara gizi kurang dengan prevalensi tuberkulosis paru (TBP) pada pasien diabetes melitus tipe 2 (DMT2). Dari keseluruhan 462 pasien DMT2, 125 pasien (27.1%) di antaranya menderita TBP. Total pasien DMT2 yang menderita gizi kurang sebesar 125 pasien (27.1%). Sementara itu, dari keseluruhan pasien DMT2 yang menderita TBP, 78 pasien (62.4%) juga menderita gizi kurang. Hasil uji chi-square menunjukkan adanya hubungan antara gizi kurang dengan prevalensi TBP yang bermakna secara statistik (p <0.000).

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Diabetes mellitus and undernutrition separately were proved as risk factors of tuberculosis incidence. This analytical cross sectional study aimed to measure the prevalence of lung tuberculosis (TBP) among type 2 diabetes mellitus (DMT2) patients and its association with undernutrition. A total of 462 DMT2 patients were analyzed and the results showed that 125 patients (27.1%) had TBP and 125 patients (27.1%) were undernourished. Within DMT2 patients who had TBP, there were 78 undernourished patients (62.4%). We concluded there is a highly significant statistical association between undernutrition and prevalence of TBP among DMT2 patients (p <0.000)."

"Atas rekomendasi dokter spesialis pelayanan Rujuk Balik ke puskesmas dianjurkan bagi pasien di RS yang menderita penyakit kronis termasuk diabetes melitius. Penelitian ini bertujuan untuk melihat faktor-faktor yang berhubungan dengan kesediaan pasien diabetes mellitus tipe 2 peserta JKN di RSU Jagakarsa untuk dirujuk balik ke FKTP.Desain potong lintang dan pendekatan kualitatif melalui wawancara mendalam digunakan dalam studi ini. Hasil penelitian menunjukkan bahwa kepercayaan pasien terhadap dokter layanan primer, persepsi pasien mengenai ketersediaan obat di fasilitas kesehatan primer, jarak tempuh terhadap fasilitas kesehatan primer dan dukungan keluarga dan teman berhubungan dengan kesediaan pasien untuk dirujuk balik. Disarankan untuk mengembangkan SOP rujuk balik di RS dan mengembangkan pojokrujuk balik.

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Back referral service to primary care is provided for JKN patients including diabetes mellitus type 2 patients as recommended by the internal medicine specialist. This studyaim is to analyse the factors that related to willingness of the patients to be referred to primary care after receiving care at the hospital in Jagakarsa Hospital. This study is using quantitative method with cross sectional design, followed by qualitative method with in depth interview.

The study revealed that trust to the primary health care physician, perception on medicine availability in primary health care facility, accessiibility and support from family and friend affect patient willingness to agree with back referral service. The study suggested to develop standard procedure for back referral and initiate back referral corner in hospital."

"Diabetes Melitus tipe 2 merupakan sekumpulan gangguan metabolik dengan karakteristik hiperglikemia. Komplikasi klinis akibat DM berkolerasi dengan status glikemik, sehingga diperlukan upaya pengontrolan status glikemik pasien DM, baik jangka pendek, jangka menengah maupun jangka panjang untuk mencegah atau mengurangi komplikasi progresif akibat penyakit tersebut. Parameter laboratorium untuk pemantauan status glikemik meliputi kadar glukosa darah harian, HbA1c, dan albumin glikat (AG). Penelitian ini bertujuan untuk mendapatkan gambaran kadar HbA1c dan kadar AG pada pasien DM tipe 2 tidak terkontrol, mendapatkan korelasi antara kadar HbA1c dan kadar AG, juga melihat penurunan kadar HbA1c dan AG sesudah terapi 1 dan 3 bulan. Penelitian dilakukan dengan desain studi diagnostik, yang melibatkan 32 subyek penelitian yang diikuti selama 3 bulan mulai bulan Februari hingga Mei 2014. Diagnosis DM tipe 2 ditegakkan oleh dokter Spesialis Penyakit Dalam dan diagnosis DM tipe 2 tidak terkontrol didapatkan dari hasil pemeriksaan HbA1c > 7 %. Hasil penelitian mendapatkan rerata (SD) kadar glukosa darah puasa bulan ke-0, ke-1, dan ke-3 berturut-turut sebesar 170,5(51,6) mg/dL; 162,7(54,6) mg/dL, dan 147,3(45,9) mg/dL. Median (rentang) kadar glukosa darah 2 jam postprandial l(G2PP) bulan ke-0 dan ke-1 sebesar 220 mg/dL (90-544) mg/dL dan 191,5 mg/dL (114-468) mg/dL; rerata(SD) kadar G2PP bulan ke-3 sebesar 201(65,98) mg/dL. Korelasi antara kadar HbA1c dan kadar AG adalah : pada bulan ke-0, r=0,79, p<0,001, bulan ke-1 r=0,74, p<0,001 dan bulan ke-3 r=0,78, p<0,001. Penurunan kadar HbA1c dari baseline (delta-1) dan pada bulan ke-3 (delta-3) adalah median (rentang) delta-1 sebesar 0,43% (0,35-0,74)%, p<0,001 dan median (rentang) delta-3 sebesar 0,89% (0,64-2,30)%, p<0,001. Penurunan kadar AG bulan ke-1 dari baseline (delta-1) dan pada bulan ke-3 (delta-3): median (rentang) delta-1 sebesar 0,94% (0,48-1,64)%, p<0,001, dan median (rentang) delta-3 sebesar 1,79% (0,33-1,40)%, p<0,001. Kami menyimpulkan bahwa terdapat korelasi positif bermakna antara kadar HbA1c dan kadar AG pada bulan ke-0, ke-1, dan ke-3, dengan kekuatan korelasi kuat (r = 0.7-0.8), selain itu terdapat penurunan kadar HbA1c dan AG yang bermakna sesudah terapi 1 dan 3 bulan.

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Type 2 diabetes mellitus (T2DM) is a group of metabolic disorders with hyperglycemic characteristic. Clinical complications of DM correlate with glycemic state, therefore it is necessary to make an effort to control DM glycemic state, in short-, medium-, and long-term to prevent or minimize progressive complications due to the disease. Laboratory parameters to monitor glycemic state include daily blood glucose, HbA1c, and glycated albumin (GA).

This study aimed to obtain HbA1c and GA levels in uncontrolled type 2 DM patients, the correlations between HbA1c and GA levels, and also the decrease in HbA1c and GA levels after 1 month and 3 months treatment. This was a diagnostic study involving 32 subjects that were followed for 3 months from February to May 2014. Type 2 DM was diagnosed by the internist in the Department of Internal Medicine and the uncontrolled type 2 DM was confirmed by HbA1c measurement of > 7%.

The results showed that mean (SD) fasting blood glucose levels at baseline, 1 month and 3 months were 170.5 (51.6) mg/dL; 162.7 (54.6) mg/dL, and 147.3(45.9) mg/dL, respectively. Median (range) 2 hours postprandial blood glucose levels at baseline and 1 month respectively, were 220 mg/dL (90-544) mg/dL and 191.5 mg/dL, respectively, and mean (SD) at 3 months was 201,7 (65,98) mg/dL. Correlations between HbA1c and GA levels : at baseline r =0.79, p<0.001, at 1 month r=0.74, p<0.001 and at 3 months r=0.78, p<0.001.

Decreases of HbA1c level from baseline, at 1 month (delta-1) and at 3 months (delta-3) : median (range) delta-1was 0.43% (0.35-0.74)%, p<0.001 and median (range) delta-3 was 0.89% (0.64-2.30)%, p<0.001. Decreases of GA level from baseline, at 1 month (delta-1) and at 3 months (delta-3) : median (range) delta-1 was 0.94%(0.48-1.64)%, p<0.001, and median (range) delta-3 was 1.79%(0.33-1.40)%, p<0.001.

We concluded that there were significant positive correlations between HbA1c and GA levels at baseline,1 month and 3 months, with strong correlations (r=0.7-0.8). In addition, there were also significant decreases in HbA1c and GA levels from baseline at 1 month and 3 months therapy."

"Pengetahuan dan pemahaman dari pasien-pasien Diabetes Melitus (DM) tipe 2 tentang penyakit dan pengobatannya adalah faktor penting untuk mempengaruhi kepatuhan. Beberapa penelitian menunjukkan bahwa edukasi kepada pasien adalah dasar untuk mewujudkan kepatuhan. Oleh karena itu, penelitian ini bertujuan untuk mengetahui korelasi antara tingkat pengetahuan tentang terapi antidiabetes oral dengan kepatuhan dalam menjalani terapi pada pasien DM tipe 2. Penelitian ini menggunakan desain crosssectional/ potong lintang dengan mewawancarai responden berdasarkan kuisioner yang disusun. Responden adalah 96 pasien DM tipe 2 di Poliklinik Penyakit Dalam RSCM Jakarta yang berusia 40 tahun ke atas dan telah menjalani terapi antidiabetes oral sedikitnya selama tiga bulan. Informasi yang diperoleh yaitu tentang karakteristik, tingkat pengetahuan dan tingkat kepatuhan pasien DM tipe 2 dalam menjalani terapi antidiabetes oral. Data dianalisis dengan menggunakan metode statistik Kai-kuadrat. Hasil penelitian ini menunjukkan bahwa ada hubungan yang bermakna antara tingkat pengetahuan tentang terapi antidiabetes oral dengan kepatuhan dalam menjalani terapi pada pasien DM tipe 2.Knowledge and comprehension of patients with type 2 Diabetes Mellitus about their disease and treatment are important factor to influence adherence. Whereas, adherence to antidiabetic oral therapy to be required for successful treatment of type 2 Diabetes Mellitus. Studies have shown that education is a cornerstone for establishing adherence. Therefore, the aim of this study is to carry out the correlation between level of knowledge about antidiabetic oral therapy and level of adherence to antidiabetic oral therapy in pasients with type 2 Diabetes Mellitus. This research used cross-sectional study design with interview respondents based on questionaire. Respondents were ninety-six type 2 Diabetes Mellitus at the interna clinic of RSCM Jakarta at age more than 40 years and have been carrying out antidiabetic oral therapy at last three months. Informations which were gotten characteristic, level of knowledge about antidiabetic oral therapy and level of adherence. Data was analyzed by using Chi-Square statistic method. The result showed that there was significant correlation between level of knowledge about antidiabetic oral therapy and level of adherence to antidiabetic oral therapy."