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"Latar Belakang. Populasi penderita DM tipe 2 semakin meningkat, seringkali disertai dengan komorbid, salah satunya depresi dengan prevalensi bervariasi. Depresi dapat mempengaruhi keluaran penyakit DM tipe 2. Beberapa obat antidepresan diketahui dapat mengganggu kontrol gula darah. Vitamin D, telah lama diketahui berkaitan dengan berbagai penyakit kronik, berpotensi memperbaiki gejala depresi, walaupun belum diketahui hubungannya.Tujuan. Mengetahui adanya hubungan antara kadar vitamin D pada pasien DM tipe dengan kejadian depresi pada pasien dengan DM tipe 2.Metode. Penelitian ini merupakan studi dengan desain potong lintang, dilakukan di Rumah Sakit Cipto Mangunkusumo (RSCM). Pasien DM tipe 2 yang memenuhi kriteria inklusi pada, dilakukan penapisan depresi menggunakan kuesioner BDI-II, kemudian dibagi menjadi dua kelompok, depresi (BDI-II ≥14) dan tanpa depresi (BDI-II <14). Kemudian kedua kelompok dilakukan pemeriksaan kadar vitamin D, dan dilakukan analisis perbedaan rerata pada kedua kelompok tersebut. Kemudian dilakukan analisis multivariat regresi logistik terhadap variabel perancu.Hasil. Dari 60 subjek dengan DM tipe 2 yang yang memenuhi kriteria, didapatkan 23 subjek (38,3%) yang depresi, dan 37 subjek (61,7%) yang tidak depresi. Didapatkan median kadar vitamin D 21,8 ng/mL (RIK 14,9-26,6) pada kelompok depresi, sementara median kadar vitamin D 26,5 ng/mL (RIK 23,96-34,08) pada kelompok tanpa depresi. Terdapat perbedaan bermakna antara keduanya (p = 0,001). Setelah dilakukan analisis multivariat dengan variabel perancu jenis kelamin, paparan sinar matahari, dan IMT, didapatkan adjusted odds ratio(adjusted OR) 1,123 (IK 95%: 1,003-1,259) dengan nilai p=0,045.Kesimpulan. Kadar vitamin D yang lebih rendah meningkatkan kejadian depresi pada pasien DM tipe 2.

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Background. The population of people with type 2 diabetes is increasing, which is often accompanied by comorbid, one of them is depression. The presence of depression can affect the outcome of type 2 diabetes mellitus. Some of antidepressants are known to interfere with blood sugar control. Vitamin D levels have long been known to be associated with a variety of chronic diseases, have the potential to improve symptoms of depression, although the relationship is not yet known.

Methods. This research is a cross sectional study conducted at Cipto Mangunkusumo Hospital. Patients with type 2 DM who met the inclusion criteria on an outpatient basis were screened for depression using BDI-II questionnaire, then divided into two groups, depressed (BDI-II ≥ 14), and without depression (BDI-II <14). Then both groups were examined for vitamin D levels using the ELISA method, and an analysis of the mean difference between the two groups was performed.

Results. From the 60 subjects with type 2 DM who met the criteria, 23 subjects (38.3%) were depressed, and 37 subjects (61.7%) were not depressed. The median of vitamin D level was 21.8 ng/mL (IQR 14.9-26.6) in the depressed group, while the median vitamin D level was 26.5 ng/mL (IQR 23.96-34.08) in the non-depressed group (p = 0.001). After doing multivariate analysis with confounding variables the adjusted odds ratio was 1.123 (95% CI: 1.003-1.259) with p value=0.045.

Conclusion. Lower levels of vitamin D increase the incidence of depression in type 2 DM patients."

"Ulkus kaki diabetik (UKD) merupakan luka kronik pada pasien diabetes melitus (DM). Vitamin D dipercaya memiliki peran penting pada diferensiasi, proliferasi, pertumbuhan sel, dan modulasi sistem imunitas sehingga kadar yang optimal dibutuhkan untuk penyembuhan luka. Defisiensi vitamin D juga diduga mengganggu produksi dan sekresi insulin sehingga berkontribusi pada kronisitas UKD. Penelitian bertujuan membandingkan kadar vitamin D pada pasien DM dengan dan tanpa UKD; serta untuk mengetahui korelasi antara durasi UKD dan keparahan UKD berdasarkan skor PEDIS (perfusion, extension, depth, infection, sensation) dengan kadar vitamin D. Serum 25-hidroksivitamin D (25(OH)D) dianalisis menggunakan in-vitro chemiluminescent immunoassay (CLIA). Analisis statistik yang sesuai dilakukan untuk membuktikan tujuan penelitian. Perbandingan nilai median (Q1-Q3) kadar vitamin D pada pasien DM dengan dan tanpa UKD secara berurutan adalah 8,90 ng/mL (6,52-10,90) dan 16,25 ng/mL (13-19,59), serta bermakna secara statistik (p<0,001). Tidak ada korelasi antara durasi UKD dan keparahan UKD berdasarkan skor PEDIS terhadap kadar vitamin D, serta tidak bermakna secara statistik. Hasil pada penelitian ini menunjukkan bahwa kadar vitamin D pada pasien DM dengan UKD lebih rendah dibandingkan pasien tanpa UKD. Namun belum ada bukti yang cukup untuk menyimpulkan bahwa tidak ada korelasi antara durasi UKD dan keparahan UKD berdasarkan skor PEDIS terhadap kadar vitamin D.

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Diabetic foot ulcers (DFU) are chronic wounds in patients with diabetes mellitus (DM). Vitamin D believed have important role in differentiation, proliferation, cell growth, and immune system modulation hence optimal levels are needed for wound healing. Vitamin D deficiency also thought to interfere insulin production and secretion, thereby contributing to DFU chronicity. This study aims to compare vitamin D levels in DM patients with and without DFU; and determine the correlation between DFU duration and severity by PEDIS (perfusion, extension, depth, infection, sensation) score to vitamin D levels. 25-hydroxyvitamin D serum analyzed using in-vitro chemiluminescent immunoassay. Appropriate statistical analysis was done following the study. Comparison of median values ​​(Q1-Q3) vitamin D levels in DM patients with and without DFU were 8.90 ng/mL (6.52-10.90) and 16.25 ng/mL (13-19.59) respectively, and statistically significant (p<0.001). There was no correlation between DFU duration and severity PEDIS score to vitamin D levels, and it was not statistically significant. The results of this study indicate that vitamin D levels in DM patients with DFU are lower than patients without DFU. However, there is not enough evidence to conclude that there is no correlation between DFU duration and severity by PEDIS score to vitamin D levels."

"Latar Belakang: Seiiring dengan bertambahnya jumlah pasien diabetes melitus tipe 2 maka angka kejadian nefropati diabetik juga ikut meningkat. Berbagai faktor telah diidentifikasi turut memperberat kejadian nefropati diabetik salah satunya status vitamin D 25(OH)D. Vitamin D memiliki efek non-kalsemik yang dapat memengaruhi sistem renin-angiotensin sehingga turut berperan dalam kejadian albuminuria. Studi sebelumnya menunjukan tingginya prevalensi defisiensi vitamin D 25(OH)D pada pasien diabetes melitus tipe 2 dan defisiensi vitamin D diduga berhubungan dengan kejadian albuminuria. Tujuan: Mengetahui asosiasi antara status vitamin D 25(OH)D dengan albuminuria pada pasien diabetes melitus tipe 2 di Indonesia. Metodologi: Dilakukan studi potong lintang pada 96 pasien diabetes melitus tipe 2 yang berobat ke poliklinik Metabolik-Endokrin RSUPN-CM. Pemeriksaan kadar vitamin D 25(OH)D menggunakan kit Diasorin dengan metode CLIA dan albuminuria dinilai berdasarkan kadar albumin pada sampel urine sewaktu. Analisis bivariat menggunakan metode chi square dan analisis multivariat menggunakan teknik regresi logistik. Hasil: Prevalensi defisiensi vitamin D 25(OH)D pada pasien diabetes melitus tipe 2 sebesar 49% dengan nilai median kadar vitamin D 25(OH)D pada pasien diabetes melitus tipe 2 adalah 16,35 ng/mL (4,2-41,4 ng/mL). Tidak didapatkan adanya hubungan yang bermakna antara defisiensi vitamin D dengan albuminuria baik pada analisa bivariat maupun multivariat (OR 0,887;IK95% 0,335-2,296). Faktor perancu seperti kontrol gula darah yang buruk dan berat badan lebih sangat mempengaruhi hubungan antara defisiensi vitamin D dengan kejadian albuminuria pada pasien diabetes melitus tipe 2. Simpulan: Studi ini belum dapat menyimpulkan adanya hubungan antara defisiensi vitamin D 25(OH)D dengan albuminuria pada pasien diabetes melitus tipe 2 di Indonesia.

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Background: In line with the increasing number of patients with diabetes mellitus type 2, the incidence of diabetic nephropathy is also increased. Various factors aggravating diabetic nephropathy have been identified, among others vitamin D 25(OH)D level. Vitamin D has a non-calcemic effect on renin-angiotensin system, causing albuminuria. Previous studies showed a high prevalence of vitamin D deficiency in patients with type 2 diabetes mellitus and it was related to the incidence of albuminuria.

Aim: To know the association between vitamin D 25(OH)D level with albuminuria in patients with type 2 diabetes mellitus in Indonesia.

Methods: A cross-sectional study was conducted in 96 patients with type 2 diabetes mellitus at outpatient clinic of Metabolic-Endocrine Cipto Mangunkusumo Hospital. Serum vitamin D level was assessed using Diasorin kit with CLIA method. Albuminuria was assessed using random urine sample. For bivariate analysis using chi square and multivariate analysis using regression logistic method.

Results: The prevalence of vitamin D 25(OH)D deficiency in patients with type 2 diabetes mellitus was 49% with a median value 16,35 ng / mL (4,2 - 41,4 ng /mL). There was no significant correlation between vitamin D deficiency with the severity of albuminuria (OR 0,887; 95% CI 0,335 to 2,296). Confounding factors such as poor blood glucose control and overweight strongly influenced the association between vitamin D deficiency with the incidence of albuminuria in patients with type 2 diabetes mellitus.

Conclusion: The results of this study have not been able to show an association between vitamin D deficiency with the severity of albuminuria in patients with type 2 diabetes mellitus in Indonesia."

"[Latar Belakang: Diabetes melitus tipe 1 merupakan diabetes yang paling sering ditemui pada anak dan remaja. Diabetes melitus dapat menimbulkan komplikasi makrovaskular dan mikrovaskular. Salah satu komplikasi mikrovaskular dari diabetes melitus adalah retinopati diabetik. Sampai saat ini, belum ada data mengenai prevalens dan faktor yang berhubungan dengan retinopati diabetik di Indonesia.Metode: Penelitian ini merupakan penelitian potong lintang menggunakan data sekunder. Jumlah subjek dalam penelitian ini sebesar 68 pasien dan data subjek didapatkan melalui arsip rekam medis pasien diabetes melitus tipe 1 di Poliklinik Endokrinologi Anak RSCM. Variabel bebas dalam penelitian ini adalah jenis kelamin, usia awitan DM tipe 1, durasi DM tipe 1, riwayat ketoasidosis diabetik, regimen insulin, kontrol glikemik, indeks massa tubuh, dan pubertas, sementara variabel terikatnya adalah kejadian retinopati diabetik.Hasil: Prevalens retinopati diabetik pada pasien anak dengan DM tipe 1 di Rumah Sakit Cipto Mangunkusumo adalah sebesar 7,4%. Dari seluruh variabel bebas yang diteliti, hanya variabel durasi DM tipe 1 yang memiliki hubungan yang bermakna secara statistik (nilai p=0,01).Kesimpulan: Prevalens retinopati diabetik pada pasien anak dengan DM tipe 1 di Rumah Sakit Cipto Mangunkusumo adalah 7,4%. Faktor yang memiliki hubungan bermakna dengan kejadian retinopati diabetik adalah durasi DM tipe 1.Saran: Penelitian ini dapat menjadi pilot study untuk penelitian mengenai retinopati diabetik kedepannya. Penelitian selanjutnya dapat dilakukan secara kohort atau case control untuk memetakan faktor risiko retinopati diabetik secara jelas. Sistem pencatatan rekam medis harus terus diperbaiki untuk mendukung iklim penelitian di dunia kedokteran Indonesia, Background: Type 1 diabetes mellitus is the most common type of childhood and adolescent diabetes. There are several macrovascular and microvascular complications associated with diabetes mellitus. Diabetic retinopathy is one of the microvascular complications. Until now, there’s no information about prevalence and risk factor of diabetic retinopathy in Indonesia.Methods: In this secondary data cross sectional study, we collected 68 subjects from Cipto Mangunkusmo Hospital. Subjects’ medical history is collected from Cipto Mangunkusumo Hospital patient’s medical record. Our independent variables are sex, age of DM onset, duration of DM, diabetic ketoacidosis history, insulin regiment, glycemic control, body mass index, and puberty, while the dependent variable is diabetic retinopathy.Results: Prevalence of diabetic retinopathy among children with type 1 diabetes in Cipto Mangunkusumo Hospital is 7.4%. We found the factor associated with diabetic retinopathy in duration of DM (p=0,01).Conclusion: Diabetic retinopathy affects about one tenth of type 1 DM patients in Cipto Mangunkusumo Hospital. Duration of DM is associated with diabetic retinopathy in type 1 DM.]"

"Tujuan Mengetahui korelasi antara kadar vitamin E plasma dengan kadar MDA dan CRP plasma pada penderita DM tipe 2Tempat Poliklinik Metabolik dan Endokrin Departemen Ilmu Penyakit Fakultas Kedokteran Universitas Indanesia/RSUPN Dr. Cipto Mangunkusumo, JakartaMetodologiPenelitian potong lintang pads 52 orang pasien DM tipe 2. Data yang diambil meliputi data demogra5, lama menderita DM tipe 2, komplikasi DM yang ada, asupan energi, lemak, dan vitamin E dengan metode food frequency questionnaire (FFQ) semikuantitatif, data laboratorium kadar vitamin E, MDA, dan CRP plasma. Data dianalisis dengan menggunakan uji korelasi Pearson.HasilSubyek terdiri dari 14 orang laki-laki dan 38 orang perempuan, dengan rerata usia 49,75 ± 5,99 tahun. Rerata lama menderita DM tipe 2 adalah 64,12 ± 60,96 bulan, 53,8% berpendidikan sedang dan tinggi, 50% berada di bawah garis kemisldnan, 79,1% telah mengalami komplikasi DM tipe 2. Rerata IMT 25,89 ± 4,89 kglm2 dan 65,4% termasuk kriteria BB lebih, rerata asupan energi 1125 ± 315,13 kkal, 61,5% mengkonsumsi lemak yang berlebih, 98,1% mempunyai asupan vitamin E yang kurang. Nilai rerata kadar vitamin E plasma 25,86 ± 5,56 p.mol/L dan 98,1% subyek mempunyai kadar vitamin E normal. Rerata kadar MDA plasma 0,38 ± 0,12 unol1L dan 94,2% subyek memiliki kadar MDA normal. Rerata kadar CRP plasma 3,88 ± 3,13 mgfL dan 46,2% subyek mempunyai kadar CRP yang tinggi. Terdapat korelasi positif lemah dan tidak bermakna (p >0,05) antara asupan lemak dengan kadar vitamin E plasma, dan antara asupan vitamin E dengan kadar vitamin E dan MDA plasma, serta korelasi negatif lemah dengan CRP plasma. Terdapat korelasi positif lemah dan tidak bermakna antara kadar HbArc dengan kadar vitamin E, MDA, dan CRP plasma. Didapatkan korelasi positif lemah dan tidak bermakna (p >0,05) antara kadar vitamin E plasma dengan kadar MDA plasma, demikian pule dengan kadar CRP plasmaKesimpulanAntara kadar vitamin E dengan kadar MDA plasma terdapat korelasi positif derajat lemah yang tidak bermakna (p >0,05), demikian pula antara kadar vitamin E plasma dengan kadar CRP plasma."

"Diabetes mellitus (DM) merupakan penyakit metabolik yang disebabkan berkurangnya sekresi hormon insulin, menurunnya sensitivitas insulin atau kombinasi keduanya. DM tipe2 merupakan salah satu jenis diabetes melitus yang paling banyak penyandangnya. Defisiensi vitamin D sering dikaitkan dengan kejadian DM tipe 2. Vitamin D merupakan salah satu vitamin yang berpotensi untuk memperbaiki sintesis dan sekresi insulin. Penelitian ini bertujuan untuk menilai pengaruh suplementasi vitamin D 5.000 IU/hari selama 3 dan 6 bulan terhadap fungsi sel beta pankreas yang dilihat dari penanda antioksidan (SOD), inflamasi (IL-6), PDX-1, HbA1c dan resistensi insulin (HOMA-IR) serta keamanan pemberian vitamin D yang dilihat dari peningkatan kadar 25-(OH)D dan ekspresi VDR.Penelitian ini menggunakan desain double blind randomized controlled trial mengikutsertakan 94 penyandang DM tipe 2 dengan usia 35‒80 tahun di Puskesmas Kecamatan Mampang Jakarta Selatan. Hasil randomisasi terdapat 47 subjek kelompok kontrol dan 47 subjek kelompok vitamin D. Kelompok kontrol mendapatkan plasebo sedangkan kelompok vitamin D mendapatkan plasebo dan vitamin D 5.000 IU selama 6 bulan. Studi dilakukan mulai bulan Januari─Desember 2022. SOD, IL-6, PDX-1, VDR, HbA1c, glukosa darah, insulin puasa, 25-(OH)D, HOMA-IR diperiksa pada awal penelitian, pascasuplementasi 3 dan 6 bulan. Analisis statistik dengan SPSS 20 menggunakan uji ANOVA general linear repeated measurement dan Mann Whitney.Karakteristik subjek penelitian pada kelompok vitamin D dan kelompok kontrol pada awal penelitian menunjukkan kedua kelompok setara baik pada karaktersitik demografis, laboratorium, dan asupan nutrien. Pascasuplementasi vitamin D selama 3 dan 6 bulan terdapat perbedaan bermakna kadar 25-(OH)D (p = 0,000), tidak terdapat perbedaan bermakna HbA1c dan glukosa darah (p = 0,360 dan p = 0,296) antara kelompok kontrol dan kelompok vitamin D. Terdapat perbedaan bermakna kadar insulin pasca suplementasi 3 dan 6 bulan (p = 0,034 dan p = 0,013) serta perbedaan bermakna HOMA-IR pasca suplementasi 3 dan 6 bulan (p = 0,033 dan p = 0,031) antara kelompok kontrol dan kelompok vitamin D. Kadar insulin pada kedua kelompok mengalami peningkatan tetapi peningkatan kadar insulin pada kelompok kontrol lebih tinggi. HOMA-IR pada kedua kelompok mengalami peningkatan tetapi peningkatan HOMA-IR pada kelompok kontrol lebih tinggi. Terdapatnya kadar insulin dan HOMA-IR yang lebih rendah pada kelompok vitamin D menunjukkan adanya perbaikan resistensi insulin.Untuk PDX-1 tidak terdapat perbedaan bermakna pasca suplementasi 3 dan 6 bulan (p = 0,464 dan p = 0,499) antara kelompok kontrol dan kelompok vitamin D. Vitamin D tidak terbukti meningkatkan SOD dan VDR serta tidak terbukti menurunkan IL-6.Simpulan: Suplementasi vitamin D 5.000 IU/hari selama 6 bulan dapat meningkatkan kadar 25-(OH)D dalam batas normal, serta dapat memperbaiki resistensi insulin melalui penurunan HOMA-IR dan penurunan sekresi insulin. Efek terhadap HbA1c, SOD, IL-6, PDX-1, dan VDR tidak terbukti.

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Diabetes mellitus (DM) is a metabolic disease that is caused by reduced insulin secretion, reduced insulin sensitivity, or a combination of the two. Type 2 DM is one of the types of diabetes mellitus with the greatest number of cases. Vitamin D deficiency is frequently associated with the incidence of type 2 DM. Vitamin D is one of the vitamins with the potential to improve insulin synthesis and secretion. This study aimed to evaluate the effect of supplementation of vitamin D at 5.000 IU/day for 3 and 6 months on pancreatic beta cell function from the perspective of antioxidant (SOD) and inflammatory (IL-6) markers, PDX-1 expression, HbA1c concentration, and insulin resistance (HOMA-IR), and the safety of vitamin D administration as shown by 25-(OH)D concentration and vitamin D receptor (VDR) expression. This study was a double blind randomized controlled trial involving 94 patients with type 2 DM aged 35‒80 years at Mampang District Public Health Center, South Jakarta. Randomization resulted in 47 subjects in the control group and 47 subjects in the vitamin D group. The control group received placebo whereas the vitamin D group received placebo and vitamin D at 5.000 IU for 6 months. The study was conducted from January‒December 2022. SOD, IL-6, PDX-1, VDR, HbA1c, blood glucose, fasting insulin, 25-(OH)D, and HOMA-IR were determined at baseline and after supplementation for 3 and 6 months. Statistical analysis by SPSS 20 used ANOVA general linear repeated measurement and Mann-Whitney tests. Characteristics of study subjects in the vitamin D and control groups at baseline showed that both groups were similar in demographic characteristics, laboratory measures, and nutrient intake. After supplementation of vitamin D for 3 and 6 months there were significant differences in 25-(OH)D concentration (p = 0.000), but no significant differences in HbA1c and blood glucose (p = 0.360 and p = 0.296) between control and vitamin D groups. There were significant differences in insulin concentration after supplementation for 3 and 6 months (p = 0.034 and p = 0.013) and significant differences in HOMA-IR after supplementation for 3 and 6 months (p = 0.033 and p = 0.031) between control and vitamin D groups. Insulin concentrations increased in both groups but the increase insulin concentrations was higher in the control group. HOMA-IR increased in both groups but the increase in HOMA-IR was higher in the control group. The lower insulin concentrations and decreased HOMA-IR in the vitamin D group indicated improve insulin resistance. With regard to PDX-1 there were no significant differences after supplementation for 3 and 6 months (p = 0.464 and p = 0.499) between control and vitamin D groups. Vitamin D was not proven to increase SOD and VDR, and was not proven to reduce IL-6.

Conclusion: Supplementation of vitamin D at 5.000 IU/day for 6 months was able to increase 25-(OH)D concentration within normal limits and was able to improve insulin resistance through reduction in HOMA-IR and decreased insulin secretion . Effects on HbA1c, SOD, IL-6, PDX-1, and VDR were not proven."

"[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.]"

"Latar Belakang : Pasien Non-Proliferative Diabetic Retinopathy (NPDR), Proliferative Diabetic Retinopathy (PDR) dengan neuropati kornea akan mengalami terganggunya stabilitas air mata. Penurunan sekresi dan konsituen air mata akan menyebabkan gangguan berupa mata kering. Pada pasien Diabetes dengan retinopati diabetik, gangguan kornea ini berpotensi lebih memperburuk gangguan penglihatan yang terjadi. Tujuan : Menilai stabilitas air mata pada pasien NPDR, PDR dengan neuropati kornea sebelum, sesudah diberikan tetes mata Sodium hyaluronat+Vitamin A,E (HA+Vit A,E) atau Sodium Hyaluronat saja (HA). Metodologi : Penelitian ini merupakan uji eksperimental randomisasi acak terkontrol, dengan dua kelompok utama (NPDR, PDR), kedua kelompok mendapatkan tetes mata HA+Vit A,E atau HA selama 28 hari. Sensitivitas kornea, Skoring Ocular Surface Disease Index (OSDI), Non-Invasive Break Up Time (NIBUT), Schirmer I, jumlah sel goblet konjungtiva dinilai pada 0, 2, 4 minggu. Hasil : 96 subyek berpartisipasi, 65.6% wanita, 34.4% laki-laki (rerata usia 54.4 tahun). Skor OSDI memperlihatkan perbaikan signifikan, nilai terbesar pada kelompok PDR HA+Vit A,E dengan -4.86±5.76 (P= 0.000), NIBUT memperlihatkan perbaikan signifikan, nilai terbesar pada kelompok NPDR HA dengan 4.79±2.63 (P= 0.000), Schirmer I memperlihatkan perbaikan signifikan, hasil terbesar pada kelompok NPDR HA dengan 2.41±2.35 (P= 0.000). Sitologi impressi konjungtiva memperlihatkan perbaikan signifikan, terutama pada kelompok NPDR HA+Vit A,E (66% perbaikan). Seluruh kelompok memperlihatkan perbaikan signifikan, tetapi perbaikan antar kelompok tidak bermakna. Kesimpulan : Parameter seluruh kelompok memperlihatkan perbaikan yang signifikan setelah diberikan tetes mata HA+Vit A,E maupun HA saja, Tetapi jika dibandingkan antar kelompok, tidak terdapat perbedaan perbaikan yang signifikan.

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Background : Patient with Non-Proliferative Diabetic Retinopathy (NPDR), Proliferative Diabetic Retinopathy (PDR) with corneal neuropathy will experiencing disruption in tear film stability. Decrease in tear film secretion and constituent will cause dry eyes. In Diabetic patients with diabetic retinopathy, this corneal disorder has the potential to further worsen visual impairment.

Purpose : To Assess tear film stability in NPDR, PDR patients with corneal neuropathy before, after treatment with topical Sodium hyaluronat+Vitamin A,E (HA+Vit A,E) or Sodium Hyaluronat only (HA).

Method : This study was a double blind experimental randomized control trial with two parallel groups (NPDR, PDR), both group receives HA+Vit A,E or HA for 28 days. Corneal sensitivity, Ocular Surface Disease Index (OSDI), Non-Invasive Break Up Time (NIBUT), Schirmer I, conjungtival goblet cells will be assessed on 0, 2, 4 weeks.

Result : 96 subjects participated, 65.6% female, 34.4% male, mean age 54.4 years old. OSDI score shows significant improvement, highest improvement seen on PDR HA+Vit A,E with -4.86±5.76 (P= 0.000), NIBUT hows significant improvement, highest improvement seen on NPDR HA with 4.79±2.63 (P= 0.000), Schirmer I shows significant improvement, highest improvement seen on NPDR HA with 2.41±2.35 (P= 0.000). Conjungtival goblet cells shows significant improvement, highest improvement seen on NPDR HA+Vit A,E (66% improved). All groups shows shows significant improvement, but between groups the improvement was not statistically significant.

Conclusion : Parameters on all groups shows statistically significant improvement after topical HA+Vit A,E or HA. But, if compared between groups, the improvement was not significantly differed."