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"Kaki Diabetik (KD) merupakan penyakit penyerta Diabetes Mellitus (DM). DM merupakan salah satu penyebab utama kasus amputasi non-traumatik di Jerman, dengan penyakit arterial perifer berat (PAP) dengan iskemia kritis tungkai yang menjadi masalah utama. Meskipun teknik modern tersedia, intervensi perkutan dan pembedahan pemulih vaskularisasi masih terbatas. Masalah ini menyebabkan peningkatan jumlah amputasi pada pasien dengan diabetes mellitus. Proses fi siologik angiogenesis, vaskulogenesis dan arteriogenesis mengarahkan ke pertumbuhan pembuluh darah kolateral pada keadaan penyakit penyumbatan pembuluh arterial penyebab iskemia tungkai. Pada praktik klinik respons angiogenik endogenik seringkali terganggu. Angiogenesis terapetik merupakan penerapan bioteknologi untuk merangsang pembentukkan pembuluh darah baru via (melalui) aplikasi lokal faktor penumbuh pro-angiogenik dalam bentuk protein rekombinan, atau terapi gen; atau dengan implantasi sel progenitor atau sel punca yang akan mensintesa sitokin angiogenik multipel. Artikel review ini merangkum fungsi endotelial dan disfungsi pada DM, mekanisme homing, metode transplantasi dan status uji klinik di bidang sel punca untuk pengobatan iskemia tungkai.

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AbstractDiabetic foot (DF) occurs as a concomitant illness of diabetes mellitus (DM). DM is one of the main causes of nontraumatic amputation in Germany with severe peripheral arterial disease (PAD) with critical limb ischemia (CLI) being of major concern. Although modern techniques are available surgical vascularisation and percutaneous intervention are limited. This problem leads increasing numbers of limb amputations in patients with diabetes mellitus. Thephysiological process of angiogenesis, vasculogenes is and arteriogenesis contribute to the growth of collateral vessels in response to obstructive arterial disease causing limb ischemi. In clinical practice the endogenous angiogenic response is often impaired. Therapeutic angiogenesis is an application of biotechnology to stimulate new vessel formation via local administration of pro-angiogenic growth factors in the form of recombinant protein, or gene therapy,or by implantation of progenitor cells or stem cells that will synthe size multiple angiogenic cytokines. This review summarises the endothelial function and dysfunctionin DM, the mechanism of homing, the transplantation method and the status of clinical trials in stem cell fi eld to treat limb ischemia."

"Latar belakang: Tujuan penelitian ini adalah untuk mengetahui efektivitas pemakaian Removable rigid dressing (RRD) dibandingkan dengan perban elastik pada pasien diabetes melitus pascaamputasi transtibia.Metode: Desain penelitian adalah studi intervensi dengan menggunakan sampling konsekutif, dilakukan randomisasi untuk membagi menjadi dua kelompok perlakuan yaitu perban elastik dan RRD. Dua puluh tiga subjek yang berhasil dianalisis. Volume edema puntung dinilai dengan mengukur jumlah volume air yang tertumpah dari gelas ukur. Volume edema dan nyeri di evaluasi setiap tujuh hari selama delapan minggu. Perban elastik harus dibalut ulang setiap empat jam per hari dan RRD dicetak ulang setiap tujuh hari saat evaluasi.Hasil: Penurunan volume edema puntung lebih cepat di kelompok RRD dibandingkan perban elastik pada minggu pertama dan kedua, secara statistik bermakna (p = 0,03, p = 0,01) serta percepatan waktu puntung menjadi tidak edema (p = 0,03). Rerata penurunan volume edema puntung di kelompok RRD sebesar 63,85% di minggu kedua, dan 34,35% di kelompok perban elastik. Terdapat kecendrungan penurunan nilai nyeri puntung yang lebih cepat di kelompok RRD (minggu 4,83 ± 1,95) dibandingkan kelompok perban elastik (minggu 5,18 ± 2,31) walaupun secara statistik tidak bermakna (p = 0,6). Analisis kesintasan dengan uji regresi Cox terhadap waktu penurunan volume edema didapatkan nilai RR = 3,088 (CI 95%: 1,128 ? 4,916).Kesimpulan: RRD mempercepat penurunan volume edema puntung dibandingkan perban elastik dan kemungkinan tiga kali lebih cepat untuk puntung menjadi tidak edema dibandingkan perban elastik. Terdapat kecenderungan lebih cepat waktu puntung menjadi tidak nyeri di kelompok RRD dibandingkan perban elastik walaupun secara statistik tidak bermakna.

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Background: The aim of this study was to evaluate the RRD?s efficacy in decreasing stump edema and pain compared to elastic bandage for diabetic mellitus patients after transtibial amputation.

Methods: Interventional research was using consecutive sampling. Subjects were randomized into two groups: RRD and elastic bandage. Twenty-three subjects were analyzed. Stump edema volume was measured by the amount of water spilled out from volume glass. Elastic bandage was reapplied every 4 hours and RRD was refitted every 7 days during evaluation time. Stump edema volume was evaluated every 7 days during the 8 week observation.

Results: There was a significant decrease of stump volume in RRD group during the first and second week (p = 0.03, p = 0.01) and the edema decreasing time was also significant (p = 0,03). The average decrease of edema volume in RRD was 63.85% of second week and in the elastic bandage group was 34.35%. There were a tendency of pain reduction time in RRD group (4.83 ± 1.95 weeks) compared to elastic bandage group (5.18 ± 2.31weeks). Cox regression result of decreasing edema volume time was 3.088 (CI 95%: 1.128 ? 4.916).

Conclusion: This study found that there was stump edema volume acceleration in RRD group, it was three times faster for stump to become not edematous compared to elastic bandage group. There was a tendency of faster decreasing stump pain in RRD group than elastic bandage group, eventhough this result was not statistically significant."

"Latar Belakang: Chronic limb threatening ischemia (CLTI) merupakan bentuk paling parah dari peripheral arterial disease (PAD). Sebanyak 25% pasien CLTI memiliki risiko amputasi tungkai mayor dan 25% lainnya akan meninggal karena penyakit kardiovaskular dalam 1 tahun. Risiko amputasi ini dapat diprediksi menggunakan sistem skoring Wound, Ischemia, and foot Infection (WIfI). Penelitian ini bertujuan untuk mendapatkan profil amputasi menggunakan skor Wound, Ischemia, foot Infection pada subjek chronic limb threatening ischemia di Rumah Sakit dr. Cipto Mangunkusumo (RSCM).Metode: Pengambilan data retrospektif dari data registrasi divisi bedah vaskular dan rekam medis pada subjek dengan CLTI di RSCM berupa profil subjek, skor WIfI, dan status amputasi mayor dalam 1 tahun pasca diagnosis CLTI ditegakkan. Data selanjutnya dimasukkan ke program SPSS, dan dilakukan analisa data. Hasil analisa lalu dipaparkan dalam bentuk narasi dan tabel.Hasil: Pada penelitian ini usia rerata subjek adalah 58,1 ± 12,9 tahun dengan predominasi jenis kelamin laki-laki (58,3%). Komorbid pada subjek dari yang tersering adalah diabetes (82,1%), hipertensi (67,9%), gagal ginjal kronis (51,3%), dan penyakit jantung (33%). Derajat skor WIfI dengan derajat sangat rendah, rendah, sedang, dan tinggi secara berurutan adalah 6,4%, 9,6%, 35,9%, dan 48,1%. Angka amputasi mayor yang sesungguhnya pada subjek CLTI di RSCM untuk skor WIfI derajat sangat rendah, rendah, sedang, dan tinggi adalah 5%, 7%, 35%, dan 70%, sedangkan pada kepustakaan adalah 3%, 8%, 25%, dan 50%.

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Background: Chronic limb threatening ischemia (CLTI) is the most severe form of peripheral arterial disease (PAD). As many as 25% of CLTI patients have a risk of major limb amputations and 25% will die due to cardiovascular event within 1 year. The risk of this major amputation can be predicted using the Wound, Ischemia, and foot Infection (WIfI) scoring system. This study aims to compare the amputation profile using Wound, Ischemia, foot Infection scores in chronic limb threatening ischemia patients at the RSCM.

Methods: Retrospective data collection from registry in vascular surgery division and medical records for patients with CLTI in RSCM were take, that is a patient profile, the comorbid disease, WIfI score, and the patient's major amputation status within 1 year after diagnosis of CLTI was established. The data then inputed to the SPSS program, and data analysis is performed. The results of the analysis are then presented in the form of narratives and tables.

Result: The mean age of the subjects in this study was 58,1 ± 12,9 years with male as gender predominance (58,3%). The comorbids in the subjects were diabetes (82,1%), hypertension (67,9%), chronic kidney failure (51,3%), heart disease (33%). The WIfI scores with very low, low, medium, and high degrees are 6,4%, 9,6%, 35,9%, and 48,1% respectively. The major amputation rates in for WIfI scores with very low, low, medium, and high degrees are 5%, 7%, 35%, and 70%, while in the literature are 3%, 8%, 25%, and 50%."

"ABSTRAKKompleksitas penanganan diabetes terlihat dari interaksi faktor yang bekerjaberlawanan. Pasien menjadi bingung dan merasa kesulitan untuk mencapaipenanganan yang optimal. Fokus penelitian ini terletak pada pasien dari kelompoksosek rendah yang mengalami stres terkait diabetes. Penerapan teknik pemecahanmasalah dapat memberikan kemampuan mengendalikan diabetes pada pasiendengan cara mengurangi stres. Teknik yang digunakan adalah relaksasi,identifikasi pikiran negatif (ABC), dan pengelolaan emosi (SSTA). Penelitian inidilakukan terhadap 3 pasien menggunakan desain kuasi-eksperimental. Ketigapartisipan mengalami penurunan stres dilihat dari berkurangnya skor DiabetesDistress Scale-17. Perubahan skor Problem Solving Test menandakan bahwapartisipan telah memahami pentingnya menerapkan problem solving untukmengurangi stres.

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ABSTRACTThe complexity of diabetes management can be seen in the interaction of severalfactors that work in opposite direction. Patients may become confused and find itdifficult to achieve optimal outcomes. This study focuses on those of lowersocioeconomic status who experience diabetes-related distress. Application ofproblem solving techniques works to provide a sense of control over diabetes byreducing stress. Various techniques used in this study are relaxation, negativethoughts identification (ABC), and negative emotion regulation (SSTA). Thisstudy was conducted using quasi-experimental design. All three participantsexperienced less stress as shown by lower average scores of Diabetes DistressScale-17. Changes in Problem Solving Test score indicates that participants haveunderstood about the importance of using problem solving techniques for dealingwith diabetes-related distress."

"Latar belakang: Penelitian ini bertujuan menilai peran berbagai adiponektin dan indeks leptin bebas terhadap dislipidemia aterogenik pada pria obesitas sentral non diabetes.Metode: Desain penelitian ini adalah potong lintang pada 120 pria obesitas sentral non-diabetes yang dilakukan di Jakarta. Parameter yang diukur adalah adiponektin total, adiponektin berat molekul tinggi, adiponektin berat molekul sedang, adiponektin berat molekul rendah, leptin, soluble leptin receptor, trigliserida, kolesterol HDL, kolesterol LDL dan apolipoprotein B (Apo B). Kriteria dislipidemia aterogenik adalah rendahnya kadar kolesterol HDL, disertai trigliserida dan small dense LDL (sdLDL) yang tinggi. Kadar sdLDL didapat dari rasio kolesterol LDL / Apo B. Indeks leptin bebas adalah rasio leptin dengan soluble leptin receptor dengan menggunakan median sebagai titik dikotomi. Dilakukan krostabulasi untuk data kategorial. Hubungan antara adiponektin multimerik, indeks leptin bebas dengan lipid aterogenik dianalisis dengan uji Spearman, selanjutnya hasil interaksi keseluruhan parameter terhadap dislipidemia aterogenik dianalisis dengan regresi logistik ganda.Hasil: Adiponektin berat molekul tinggi berkorelasi negatif secara bermakna dengan dislipidemia aterogenik (p< 0,05), sedangkan adiponektin berat molekul sedang dan adiponektin berat molekul rendah tidak berkorelasi (p> 0,05) dengan dislipidemia aterogenik. Indeks leptin bebas berkorelasi positif secara bermakna dengan dislipidemia aterogenik (p< 0,05). Odds Rasio (OR) adiponektin berat molekul tinggi terhadap kejadian dislipidemia aterogenik adalah 3,62 (p< 0,05), sedangkan risiko dislipidemia aterogenik pada subyek dengan indeks leptin bebas rendah adalah 4,57 (p< 0,05).Kesimpulan: Adiponektin berat molekul tinggi dan indeks leptin bebas berperan dalam meningkatkan risiko dislipidemia aterogenik. (Med J Indones 2011; 20:119-24).

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AbstractBackground: To analyze the role of various adiponectin and free leptin index on the occurrence of atherogenic dislipidemia in non-diabetic central obese menMethods: This is a cross-sectional study on 120 non-diabetic central obese men that was done in Jakarta. The measured indicators were total adiponectin, high molecular weight adiponectin (HMW adiponectin), medium molecular weight adiponectin (MMW adiponectin), low molecular weight adiponectin (LMW adiponectin), leptin, soluble leptin receptor, triglycerides, high-density lipoprotein cholesterol (HDL cholesterol), low density lipoprotein cholesterol (LDL cholesterol) and apolipoprotein B (Apo B). Atherogenic dyslipidemia was characterized by reduced level of HDL cholesterol, and high levels of triglyceride and small dense LDL (sdLDL). Ratio of LDL cholesterol and Apo B were calculated to get sdLDL. Free Leptin Index (FLI) was the ratio between total leptin and soluble leptin receptor (sOB-R), and median values were used as cut off to defi ne high and low values of each parameter. Cross tabulation were done on categorical data. Relationships between multimeric adiponectin and free leptin index with atherogenic lipids were analyzed by using Spearman analysis. Further, the interaction of all indicators with the occurence of atherogenic dyslipidemia was analyzed using binary logistic regression.Results: A negative correlation of HMW adiponectin with atherogenic dyslipidemia (p< 0.05), whereas there were no correlation between MMW adiponectin and LMW adiponectin with atherogenic dyslipidemia (p> 0.05). Free Leptin Index was associated positively with atherogenic dyslipidemia (p< 0.05). Odds Ratio (OR) of HMW adiponectin for the occurrence of atherogenic dyslipidemia was 3.62 (p< 0.05), where as OR of FLI with atherogenic dyslipidemia was 4.57 (p< 0.05).Conclusion: HMW Adiponectin and FLI might contribute to atherogenic dyslipidemia in central obese non-diabetic males. (Med J Indones 2011; 20:119-24)."

"Diabetes melitus merupakan gangguan metabolisme karbohidrat, protein dan lemak karena menurun atau tidak berfungsinya aktivitas insulin, sehingga kadar glukosa dalam darah meningkat. Penanganan diabetes dapat dilakukan dengan antidiabetik oral, insulin dan inhibitor α-glukosidase. Penelitian terdahulu membuktikan tanaman dari famili Euphorbiaceae memiliki aktivitas penghambatan terhadap α-glukosidase seperti ekstrak etanol Antidesma celebicum dengan nilai IC50 5,60 μg/mL. Penelitian ini bertujuan untuk memperoleh fraksi teraktif dari ekstrak methanol kulit batang Antidesma celebicum Miq. dalam menghambat aktivitas α-glukosidase serta mengetahui kandungan senyawa kimia dari fraksi teraktif. Ekstrak metanol difraksinasi cair-cair dengan pelarut n-heksan, etil asetat dan metanol.Fraksi yang diperoleh diuji penghambatannya terhadap aktivitas α-glukosidase menggunakan microplate reader pada λ=405 nm. Aktivitas penghambatan paling besar ditunjukkan oleh fraksi etil asetat (IC50 90,11 μg/mL). Selanjutnya fraksi etil asetat difraksinasi dengan kromatografi kolom dan diperoleh 8 fraksi gabungan (A-H). Aktivitas penghambatan α-glukosidase paling baik ditunjukkan oleh fraksi gabungan E (etil asetat:metanol) dengan IC50 53,68 μg/mL. Penapisan fitokimia menunjukkan fraksi etil asetat dan fraksi gabungan E mengandung glikosida, fenol, saponin dan terpen.

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Diabetes mellitus is a metabolic disorder in which carbohydrate, protein and fat due to decreased or malfunctioned activity of insulin, resulting in increased blood glucose levels. Treatment for diabetes can be done with oral antidiabetic, insulin and α- glucosidase inhibitor. The previous researches showed the plants of the family Euphorbiaceae have inhibitory activity against α-glucosidase such as Antidesma celebicum ethanol extract with IC50 values 5.60 μ/mL. This research aimed to get most active fraction from methanol extract of stem bark Antidesma celebicum Miq. that have inhibition against α-glucosidase inhibitory activity and determine it is chemical substance. Methanol extract is fractionated liquid-liquid using solvents of nhexane, ethyl acetate, and methanol. The results of fraction, then, is inhibitory tested against α-Glucosidase activity using a microplate reader at λ= 405 nm. The greatest inhibitory activity is shown by ethyl acetate fraction (IC50 value 90.11μ/mL). Ethyl acetate fraction further fractionated by column chromatography and the combined fractions E (ethyl acetate :methanol) showed the strongest α-Glucosidase inhibitory activity with IC50 value 53.68 μ/mL Phytochemical screening showed extract ethyl acetate and combined fractions E contained glycosides, phenols, saponins and terpenes."

"[ABSTRAKKerentanan lansia terhadap masalah kesehatan seperti diabetes mellitus meningkat seiring dengan bertambahnya usia. Karya Ilmiah Akhir ini mengintegrasikan teori manajemen pelayanan keperawatan dan tiga model keperawatan yaitu Community as Partner, Family Centred Nursing dan Functional Consequencies. Asuhan keperawatan diberikan pada 32 lansia diabetisi di kelurahan Sukamaju Baru selama 9 bulan. Intervensi inovasi yang dikembangkan adalah booklet DM yang didasari pada program CERDIIK Kemenkes RI, Diabetes Self Management Education (DMSE) dan empat pilar penatalaksanaan DM. Hasil intervensi yang dilakukan menunjukkan adanya perubahan perilaku lansia diabetisi, kelompok pendukung dan sebaya dalam melakukan penatalaksanaan DM. Penurunan rata-rata kadar gula darah lansia kelompok sebaya sebesar 101,5 poin. Penggunaan booklet DM efektif dalam mengontrol kadar gula darah lansia diabetisi dengan wadah kelompok sebaya dan dukungan kader kelompok pendukung. program ini diharapkan dapat diteruskan dengan peningkatan keterlibatan keluarga, kader dan tenaga kesehatan.

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ABSTRACTThe vulnerability of the elderly to health problems such as diabetes mellitus increases with age. This final internship report integrated nursing service management theory with three nursing models, which are Community as Partner, Family Centred Nursing dan Functional Consequencies. A nursing care was provided to 32 elderly with diabetic at district Sukamaju Baru for 9 months. An innovative intervention was developed that was DM booklet based on CERDIIK program from Ministry of Health Indonesia, Diabetes Self Management Education (DMSE) and the four pillars of DM management of care. Result of intervention showed changes of healthy behavior from elderly with DM, support group dan peer group in providing DM care management. There was a reduce of elderly blood glucose level in average about 101,5 poin. The DM booklet usage was effective in controlling blood glucose level of elderly with DM who actively involved in peer group and support group of community workers. This program was expected to be sustained and get more family involvement, as well as involvement from community workers and health workers. , The vulnerability of the elderly to health problems such as diabetes mellitus increases with age. This final internship report integrated nursing service management theory with three nursing models, which are Community as Partner, Family Centred Nursing dan Functional Consequencies. A nursing care was provided to 32 elderly with diabetic at district Sukamaju Baru for 9 months. An innovative intervention was developed that was DM booklet based on CERDIIK program from Ministry of Health Indonesia, Diabetes Self Management Education (DMSE) and the four pillars of DM management of care. Result of intervention showed changes of healthy behavior from elderly with DM, support group dan peer group in providing DM care management. There was a reduce of elderly blood glucose level in average about 101,5 poin. The DM booklet usage was effective in controlling blood glucose level of elderly with DM who actively involved in peer group and support group of community workers. This program was expected to be sustained and get more family involvement, as well as involvement from community workers and health workers. ]"

"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."

"Piper cf. fragile, Benth dan Centella asiatica, (L.) Urb telah diketahui berpotensi menyembuhkan luka. Tujuan dari penelitian ini adalah untuk mengetahui efek penyembuhan luka diabetes dari kombinasi infusa daun Piper cf. fragile, Benth dan herba Centella asiatica, (L.) Urb pada luka tikus yang diabetes. Hewan uji dibagi menjadi 7 kelompok dan dilukai menggunakan metode Morton. Semua kelompok diinduksi aloksan secara intraperitoneal dengan dosis 32 mg/200 g BB tikus kecuali kelompok 1. Kelompok I sebagai kontrol normal menerima akuades dan kelompok II sebagai kontrol induksi. Kelompok III diberi glibenklamid dengan dosis 0,9 mg/200 g BB tikus, kelompok IV diberi infusa dosis tunggal daun Piper cf. fragile, Benth dan kelompok V, VI dan VII diberi kombinasi infusa daun Piper cf. fragile, Benth dan herba Centella asiatica, (L.) Urb. Persentase penyembuhan luka dianalisis secara statistik dengan uji ANAVA satu arah. Hasilnya menunjukkan tidak ada perbedaan bermakna antar kelompok perlakuan selama 8 hari perlakuan.

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Piper cf.fragile, Benth. and Centella asiatica, (L.) Urb were evaluated for their wound healing potential. The aim of this study was to assess the wound healing effect of a combination of Piper cf. fragile leaves and Centella asiatica, (L.) Urb herbs infusions on diabetic male rats. Rats divided into 7 groups and experimentally wounded by Morton methode. All groups received intraperitoneally 32 mg/ 200 g bw of alloxan except group I. Group I was normal control received aquadest and group II was induced control. Group III received 0.9 mg/200 bw of glibenclamide, group IV had been treat with a single dose of Piper cf.fragile, Benth leaves infusions and group V, VI and VII had been given a combination of Piper cf. fragile leaves and Centella asiatica, (L.) Urb herbs infusions. The percentage of wound healing analized statistically by one way ANOVA. The result showed no significant different between groups for 8 days treatment."

"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"