Hasil Pencarian  ::  Simpan CSV :: Kembali

"ABSTRAKLatar belakangOsteoarthritis (OA) adalah salah satu penyakit yang paling tua dalam sejarah manusia. Meskipun demikian, persoalan OA sekarang menjadi jauh lebih banyak, Iebih nyata dan lebih bermakna dengan semakin bertambah panjangnya usia.Hasil pengobatan terhadap penyakit ini sampai sekarang masih belum memuaskan oleh karena patogenesisnya belum dapat dipahami dengan baik. Pendekatan epidemiologik yang biasa untuk mengetahui patogenesis OA sebagai suatu keseluruhan dipandang masih belum cukup. Hal itu masih perlu dilengkapi dengan penelitian patogenesis OA pada populasi tertentu, misalnya pada diabetes melitus.Meskipun OA dan diabetes melitus merupakan penyakit yang sering dijumpai, terutama pada orang lanjut usia, kaitan antara kedua keadaan ini belum banyak terungkap. Berbeda dengan komplikasi mikroangiopati, makroangiopati atau neuropati, komplikasi muskuloskeletal diabetes melitus, khususnya OA, kurang dibicarakan. Tak mengherankan kalau dalam konggres International Diabetes Federation yang terakhir (1991), OA telah digolongkan sebagai "overlooked diabetes complications".OA timbul lebih sering, lebih awal dan menimbulkan keluhan yang lebih nyata pada orang-orang dengan diabetes melitus. Prevalensi DISH (Diffuse Idiopathic Skeletal Hyperostosis), salah satu bentuk simpangan OA, pada penderita diabetes melitus adalah 115-13,5%, yang hampir dua kali dari Prevalensi pada non diabetes. Sebaliknya, intoleransi glukosa juga ditemukan jauh lebih banyak (sampai 23%) diantara penderita-penderita DISH. Dua penelitian radiografi menemukan bahwa frekuensi osteofit pada kaki dan tangan dijumpai Iebih sering pada diabetes daripada non diabetes.Penelitian klinik dan radiografik yang dilakukan di RS.Dr. Saiful Anwar Malang juga menemukan kaitan yang serupa. Tanda-tanda radiografik perubahan degeneratif sendi kaki ditemukan pada 15.1% diantara 172 penderita diabetes melitus (usia 32-55 tahun) dibanding pada 8.7% kontrol non diabetes sesuai jenis kelamin dan umumya. Diantara penderita diabetes melitus yang berobat jalan terdapat 50% penderita dengan artrosis (1eher) dibanding 23% pada kontrol.Hasil penelitian-penelitian klinik tersebut disokong oleh hasil penelitianpenelitian pada binatang percobaan. Diskus intervertebra tikus diabetes terbukti mengalami perubahan-perubahan degeneratif yang lebih cepat daripada tikus non diabetes. Disamping itu, spondilosis deforman timbul lebih berat pada tikus diabetes. Pada tulang rawan sendi tikus diabetes timbul perubahan enzim-enzim penghancuran proteoglikan dan kolagen yang dapat dinormalkan kembali dengan tranplantasi pankreas. Pada jaringan tersebut juga terdapat perubahan komposisi kolagen dan proteoglikan matrik.Adanya kaitan antara diabetes dan OA menyokong konsep tentang peranan faktor metabolik dan hormonal pada patogenesis OA. Hormon pertumbuhan (HP), insulin, estradiol dan faktor pertumbuhan seperti insulin-1 (FPI-1) terbukti mempunyai pengaruh nyata pada metabolisme tulang rawan sendi. Adanya perubahan aktivitas hormon tersebut dapat berkaitan dengan patogenesis OA. Meningkatnya HP pada akromegali merangsang pembentukan tulang baru dan hipertropi tulang rawan sendi yang menyerupai gambaran OA.Bagaimana patogenesis OA sebagai salah satu komplikasi menahun diabetes melitus dapat dijelaskan dengan konsep 2 jalur umum patogenesis OA. kerusakan tulang rawan sendi dan reaktivasi pertumbuhan tulang rawan sendi.

---

ABSTRACT

Introduction

It is known that diabetes mellitus (DM) increases the risk of osteoarthritis, however the factors play important role in its pathogenesis has not established yet. Osteoarthritis is characterized by joint cartilage degradation and bone formation.

Many studies reported that the duration of DM and the metabolic control in DM become important factors in the development of chronic diabetic complications. It is suggested that some hormones are increased in diabetics, such as insulin, growth hormone (OH), insulin like growth factor-1 (IGF-1) and estradiol. Those hormones are known to promote metabolic action in bone and cartilage joints.

Therefore, some factors that influence the pathogenesis mechanism in DM increased the risk of OA, of which are the level of insulin, GH, 1GF-1 and estradiol serum concentrations, the duration of diabetes and the severity of hyperglycemia.

It is hypothized that the duration of DM and good metabolic control could increase the risk of QA in diabetics. There is a basic concept that the level of insulin, HP1 FPI-1 and estradiol could be risk factors for OA among the diabetics.

The aim of this research is to determine the role of the duration of suffering DM, metabolic control, concentration of insulin, GH, IGF-1 and estradiol in the occurrence of OA among the diabetics.

Material and methods

This study was conducted in the Metabolic and Endocrine clinic of the Dr. Saiful Anwar Hospital in Malang during 1988 up to 1991. Sampling was "purposive" collected among the diabetics (n= 372) who has non obese non insulin dependent diabetes, average body mass index (BMI) = 22.56 + 4.11, ages more than 44 years old, average age= 59.13 + 7.96 years, and onset of DM is older than 30 years.

A case control study to the duration of DM (more or less than 8 years) and the metabolic control was used on this study. Good metabolic control was determined by the average of fasting blood glucose < 120 mg/dl, the compliance of patients and the blood level of fructosamine (< 3 mmol/l). The role of each risk factor was shown by odds ratio (OR).

Radiography of the knee was taken in all samples, to find out knee osteoarthritis (KOA), using diagnostic criteria and gradation of Kellgreen and Lawrence , besides getting the clinical symptoms among the diabetics based on the ARA criteria.

To evaluate the risk of OA in diabetics, the similar study was conducted among the 172 samples non obese (ages and BMI matched). The exclusion criteria are other joint diseases than KOA, obesity, history joint injury and lower extremities paralyses.

Radio immuno assays was measured among the 30 cases of KOA, 30 cases without KOA, for good and poor metabolic control. The assays included the concentration of blood insulin, GH, IGF-1 and estradiol. The results of concentration of serum hormones are statistically analyzed by ANOVA.

In this study was also observed the possible correlation between KOA and high level of insulin related to the complication of diabetes, such as hypertension, Coronary Heart Disease and lipid disturbance. The clinical finding was determined to see the possible correlation KOA in diabetics and the peripheral neuropathy and also diabetes retinopathy."

"Tujuan penelitian ini adalah untuk mengetahui profil kesehatan gigi mulut serta distribusi frekuensi sosioekonomi dan perilaku dari pasien diabetes melitus tipe 2 di RSCM. Studi potong lintang ini dilakukan dengan memberikan kuesioner pada 70 orang pasien dan dianalisis menggunakan uji Pearson. Hasil uji tersebut tidak menunjukkan hubungan bermakna antara pengetahuan, sikap, durasi, dan sosioekonomi pasien terhadap status kesehatan gigi dan mulut (p>0,05). Hasil penelitian memperlihatkan kurangnya pengetahuan pasien diabetes melitus terhadap dampak diabetes melitus terhadap kesehatan gigi dan mulut sedangkan pengetahuan tentang komplikasi diabetes baik. Dari hasil pemeriksaan klinis dapat disimpulkan bahwa kesehatan gigi dan mulut pasien diabetes kurang memuaskan.

---

The purpose of this study is to obtain information about the oral health profile, socioeconomic status and dental behavior of Type 2 Diabetes Mellitus patients in RSCM. A cross sectional study was conducted by giving out questionnaire to 70 diabetic patients and were analyzed by Pearson test. There are no significant correlation between diabetic patients’ knowledge, dental behavior, diabetes duration, and socioeconomic status to oral health status. This study showed that patients had lack of awareness of diabetes effects on oral health but good in diabetes complications. From the clinical examination, diabetic patients’ oral health status were not good."

"ABSTRAKPenelitian bertujuan mengetahui pengaruh senam kaki terhadap sensitivitas kakidan kadar gula darah pada aggregate lansia diabetes melitus di Magelang.Penelitian eksperimen semu desain pre and post test group design with controlgroup. Sampel secara aksidental atau convenience sampling, 125 responden (62lansia kelompok intervensi dan 63 kelompok kontrol). Instrumen penilaianmenggunakan skala sensitivitas dan nilai kadar gula darah. Senam kaki dilakukan3 kali seminggu selama 4 minggu. Hasil penelitian kadar gula darah lebih baikpada lansia sesudah diberikan senam kaki (p value 0,000). Sensitivitas kaki lebihbaik pada lansia sesudah diberikan latihan senam kaki (p value 0,000).

---

AbstractThe study aimed to determine the effect of leg exercise on the feet sensitivity andblood sugar levels in elderly with diabetes melitus at Magelang. It applied quasiexperimentaldesign with accidental sampling to 62 elderly in intervention groupand 63 elderly in control group. Assessment instruments used the scale sensitivityof blood sugar levels. Leg exercises activities performed 3 times a week for 4weeks. The results showed better blood sugar levels after a given leg exercises aswell as leg sensitivity). A series of leg exercise is recommended to be done bycommunity nurses to the elders."

"Diabetes melitus merupakan suatu kelompok penyakit metabolik dengan hiperglikemia sebagai karakteristik utama. Hiperglikemia terjadi karena kelainan sekresi insulin, kerja insulin, dan atau keduanya. Sekitar 50% penyandang diabetes di Indonesia belum terdiagnosis sehingga komplikasi akibat DM tidak dapat dihindari. Pengendalian terjadinya komplikasi dilakukan dengan kontrol glikemik secara teratur. Pemeriksaan kontrol glikemik antara lain dengan glukosa darah puasa, HbA1c, dan fruktosamin. Penelitian ini bertujuan untuk melihat gambaran kadar fruktosamin dan HbA1c pada diabetes melitus tipe 2 tidak terkontrol, mengetahui perubahan kadar fruktosamin dan HbA1c setelah terapi 2 minggu dan 8 minggu, serta hubungan antara keduanya. Penelitian ini menggunakan desain kohort prospektif pada 33 subyek yang terdiri dari 24 orang perempuan dan 9 orang laki-laki. Subyek penelitian diikuti selama 2 minggu dan 8 minggu sejak dilakukan perubahan terapi. Penelitian dimulai pada bulan Februari sampai April 2015. Subyek yang termasuk dalam penelitian adalah diabetes mellitus tipe 2 yang tidak terkontrol dengan HbA1c>7%. Hasil penelitian diperoleh nilai median dan rentang fruktosamin pada minggu ke-0, minggu ke-2, dan minggu ke-8 berturut-turut 362 μmol/L (257-711), 327 μmol/L (234-616), dan 350 μmol/L (245-660). Kadar HbA1c memiliki nilai median dan rentang pada minggu ke-0, minggu ke-2, dan minggu ke-8 yaitu 9.3% (7.1-14.8), 8.8% (6.9-12.7), dan 8.4% (5.9-14.2). Terdapat penurunan bermakna kadar fruktosamin dan HbA1c dengan p<0.001. Adanya korelasi yang kuat dan arah korelasi yang positif antara fruktosamin dan HbA1c (minggu ke-0, r=0.86; minggu ke-2, r=0.82; minggu ke-8, r= 0.84). Pada penelitian ini diperoleh penurunan yang bermakna kadar fruktosamin dan HbA1c pada 2 minggu dan 8 minggu setelah terapi dengan korelasi yang kuat ( r > 0.8) dan arah korelasi positif. Fruktosamin lebih baik digunakan untuk kontrol glikemik jangka menengah (2 minggu) sedangkan HbA1c lebih baik dipakai untuk kontrol glikemik jangka panjang (8 minggu).

---

Diabetes mellitus is a group of metabolic diseases with hyperglycemia as the main characteristics. Hyperglycemia occurs due to abnormalities in insulin secretion, insulin action, or both. Approximately 50% of people with diabetes in Indonesia have not been diagnosed, thus complications due to diabetes cannot be avoided. Taking control of diabetes mellitus can be done through glycemic control measurements on a regular basis. Fasting blood glucose, HbA1c, and fructosamine tests are lists of key features for glycemic control measurements.

The aims of this study was to overview the levels of fructosamine and HbA1c in uncontrolled type-2 diabetes mellitus, determine changes in fructosamine and HbA1c levels after two weeks and eight weeks of treatment, and analyze the relationship between the two.

This study used a prospective cohort design with 33 subjects consisted of 24 women and 9 men. Subjects were followed for two weeks and eight weeks after the initial therapy amendment. The study began in February and April 2015. The subjects included in the study were uncontrolled type-2 diabetes mellitus with HbA1c> 7%.

Fructosamine concentration, given as median and range values, at weeks 0, 2, and 8 were 362 μmol/L (257-711), 347 μmol/L (234-660), and 333 μmol/L (235-676), respectively. HbA1c levels (median and range) at weeks 0, 2, and 8 were 9.3% (7.1-14.8), 8.8% (6.9-12.7) and 8.4% (5.9-14.2). There was a significant reduction of fructosamine and HbA1c levels (p <0.001). A strong and positive correlation were found between fructosamine and HbA1c (week 0, r = 0.86; week 2, r = 0.82; week 8, r = 0.84).

From this study, it can be concluded that fructosamine and HbA1c levels were significantly reduced at weeks 2 and 8 after treatment, with a positive strong correlation (r> 0.8). Thus, fructosamine is preferable for medium-term (two weeks) glycemic control while the HbA1c is preferred for long-term (eight weeks) glycemic control."

"ABSTRACTOsteoarthritis genu adalah penyakit sendi degeneratif perusakan kartilago artikular dan tulang subkondral berujung disabilitas. Diabetes melitus sebagai komorbid osteoartritis genu menyebabkan kekakuan matriks ekstraseluler, kerusakan tulang subkondral, dan disfungsi kondrosit. Tujuan penelitian untuk mencari perbedaan bermakna status pasien osteoartritis genu komorbid diabetes melitus dengan perubahan nilai verbal numeric analog scale pasca terapi. Desain penelitian cross sectional dengan teknik sampling consecutive sampling. Jumlah sampel 72 36 komorbid diabetes melitus dan 36 non komorbid . Analisis data menggunakan uji saphiro-wilk dan Mann-Whitney. Selisih nilai diperoleh melalui pengurangan nilai terakhir pasca terapi dengan nilai saat kunjungan pertama pada rekam medik 2015. Hasil penelitian menunjukkan pasien osteoartritis genu memiliki rentang usia 61-70 tahun 36,1 , mayoritas perempuan 66,7 , dan jenis terapi TENS 58,3. Rerata selisih VNAS OA genu komorbid DM 1,6389, dan OA genu tanpa komorbid DM 2,6389. Hasil uji statistika menunjukkan perbedaan bermakna antara status pasien OA genu diabetes melitus dengan selisih VNAS P 0,024.

---

ABSTRACTKnee osteoarthtritis, a joint degenerative disease, the process of which include damage of knee articular cartilage and subchondral bone that may caused dissabilitation. Diabetes mellitus as a comorbid for this disease that may cause joint extracellular matrix rigidity, subchondral bone defect, and chondrosite dysfunction. Research purporse is finding the significant difference between diabetes mellitus status on knee osteoarthtritis and verbal numeric analog scale score changes after treatment. This research use cross sectional design and consecutive sampling technique. Total sample is 72 medical records. Analyzing the data by using Shapiro wilk and Mann whitney test. Score changes is a score gained by reducing the final pain score with the initial one in the medical record. The results are common age having knee osteoartrtis 61 70 years old 36,1 , woman gender majority 66,7 , and TENS treatment 58,3 . Mean pain score changes of knee osteoarthritis with diabetic comorbidity and knee osteoarthritis without diabetic comorbidity are 1,6389 and 2,6389. Statistic test shows significant difference between diabetes mellitus status on knee osteoarthtritis and verbal numeric analog scale VNAS score changes after treatment P 0,024. "

"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).

---

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)."

"Tuberkulosis (TB) paru merupakan penyakit infeksi dengan prevalensi tinggi di Indonesia. Berbagai studi meneliti tentang faktor risiko TB, antara lain diabetes melitus (DM) dan kadar hemoglobin. Studi cross-sectional analitik ini bertujuan untuk mengetahui ada tidaknya hubungan antara kadar hemoglobin terhadap prevalensi TB paru pada penderita DM tipe 2. Dari hasil penelitian diketahui bahwa tidak terdapat perbedaan yang bermakna secara statistik antara kadar hemoglobin <10 g/dL dan 210 g/dL terhadap prevalensi TB paru pada diabetes melitus tipe 2 di RSCM pada tahun 2010. Hasil penelitian menyarankan dilakukannya penelitian serupa di rumah sakit lainnya pada tahun tertentu.

---

Pulmonary tuberculosis (TB) is one of the infectious diseases with high prevalence in Indonesia. Many studies observe the risk factors of TB such as diabetes mellitus (DM) and hemoglobin level. This analytic cross-sectional study observes whether there is an association between hemoglobin level and pulmonary TB prevalence in patients with DM type 2. From this study, there is no statistically significant difference between hemoglobin level <10 g/dL compared to 210 g/dL to the pulmonary TB prevalence in patients with DM type 2 in Cipto Mangunkusumo Hospital in 2010. It is suggested to do same studies at other hospitals in other year."

"[ABSTRAKLatar belakang: mengetahui hubungan antara asupan makronutrien dan gayahidup terhadap status HbA1c penyandang diabetes melitus (DM) tipe 2. Metode:penyandang DM tipe 2 dikategorikan ke dalam 2 kelompok, yaitu kontrolglikemik (KG) baik (HbA1c < 7,0) dan KG buruk (HbA1c > 7,0). Datakarakteristik dasar seperti usia, jenis kelamin, status gizi, durasi menderita DM,jenis dan jumlah obat DM yang digunakan, serta ada/ tidaknya komplikasi DMyang diderita. Asupan makronutrien terdiri dari asupan energi total harian, asupankarbohidrat, protein, lemak dan serat. Faktor gaya hidup meliputi ketaatanmengikuti diet sesuai yang direkomendasikan, aktivitas fisik, ketaatan konsumsiobat, merokok dan minum alkohol. Data-data dari kedua kelompok kemudiandihubungkan dengan status HbA1c dengan uji Chi square. Hasil penelitian: usiapenyandang DM yang lebih muda (< 55 tahun), asupan karbohidrat dan ketaatanmengikuti diet berhubungan bermakna secara statistik dengan status HbA1c (P <0,05). Rasio asupan makronutrien (karbohidrat, protein, lemak) pada kelompokKG baik adalah 47: 18: 35 dan KG buruk 51: 16: 33. Kesimpulan : Hasilpenelitian ini menunjukkan bahwa status HbA1c berhubungan bermakna denganfaktor usia, asupan karbohidrat, dan ketaatan mengikuti diet. Edukasi sebaiknyadiberikan kepada penyandang DM tipe 2 dengan KG buruk, terutama yang berusia< 55 tahun agar mengatur pola makannya sesuai dengan yang direkomendasikandengan memperhatikan jenis, jumlah, dan jadwal.

---

ABSTRACTBackground: Determining the relationship between macronutrients intake and lifestylefactors and HbA1c status of diabetic type 2 patient in improving the effectiveness ofpatient?s nutrition therapy and preventing diabetes complications. Methods: Diabetictype 2 patients were categorized into 2 groups; patients with good glycemic control (GC)or HbA1c < 7.0 and patients with poor glycemic control (PC) or HbA1c > 7.0. Clinicalcharacteristics were differentiated by age, gender, body mass index (BMI), duration ofillness, type and amount of diabetic medication, and other diabetic complication.Macronutrient intake consisted of total daily calories and carbohydrate, protein, fat andfiber intakes. Lifestyle factors consisted of the adherence to dietary advice andmedication, physical activities, smoking habit, and alcohol intake. The data were be usedto determine their relationship with HbA1c status using Chi Square test. Results:Younger diabetic type 2 patients (< 55 years old), carbohydrate intake, and adherence todietary advice were identified as statistically significant variables related to HbA1c status(P <0.05). Macronutrient intake ratio (carbohydrate : protein : fat) for GC was 47 : 18 : 35and PC was 51 : 16 : 33. Conclusions: The results demonstrate that HbA1c status indiabetic type 2 patient are related to age, carbohydrate intake and adherence to dietaryadvice. Education to be provided to younger diabetic type 2 patients (<55 years old) tomaintain good dietary pattern according to medical nutrition therapy, Background: Determining the relationship between macronutrients intake and lifestylefactors and HbA1c status of diabetic type 2 patient in improving the effectiveness ofpatient’s nutrition therapy and preventing diabetes complications. Methods: Diabetictype 2 patients were categorized into 2 groups; patients with good glycemic control (GC)or HbA1c < 7.0 and patients with poor glycemic control (PC) or HbA1c > 7.0. Clinicalcharacteristics were differentiated by age, gender, body mass index (BMI), duration ofillness, type and amount of diabetic medication, and other diabetic complication.Macronutrient intake consisted of total daily calories and carbohydrate, protein, fat andfiber intakes. Lifestyle factors consisted of the adherence to dietary advice andmedication, physical activities, smoking habit, and alcohol intake. The data were be usedto determine their relationship with HbA1c status using Chi Square test. Results:Younger diabetic type 2 patients (< 55 years old), carbohydrate intake, and adherence todietary advice were identified as statistically significant variables related to HbA1c status(P <0.05). Macronutrient intake ratio (carbohydrate : protein : fat) for GC was 47 : 18 : 35and PC was 51 : 16 : 33. Conclusions: The results demonstrate that HbA1c status indiabetic type 2 patient are related to age, carbohydrate intake and adherence to dietaryadvice. Education to be provided to younger diabetic type 2 patients (<55 years old) tomaintain good dietary pattern according to medical nutrition therapy]"

"Latar belakang: Gagal jantung merupakan beban baik dalam hal prognostik maupun sosial ekonomi. Gagal jantung dan diabetes melitus tipe 2 (DMT2) saling mempengaruhi luaran klinis pasien. Empagliflozin, suatu penghambat SGLT2, merupakan agen antihiperglikemia baru yang terbukti dapat menurunkan mortalitas dan hospitalisasi akibat gagal jantung. Beberapa mekanisme efek proteksi empagliflozin terhadap kardiovaskular telah dibuktikan melalui studi pada hewan. Empagliflozin memiliki efek meningkatkan fungsi sistolik ventrikel kiri pada hewan coba. Namun efek Empagliflozin terhadap fungsi sistolik intrinsik ventrikel kiri pada pasien DMT2 dengan gagal jantung belum diketahui.Tujuan: Mengetahui pengaruh pemberian Empagliflozin terhadap fungsi sistolik intrinsik ventrikel kiri pada pasien DMT2 dengan gagal jantungMetode: Penelitian ini merupakan uji klinis acak tidak tersamar yang dilakukan di poliklinik Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita (RSJPDHK) pada pasien DMT2 dengan gagal jantung. Kelompok yang mendapat Empagliflozin 10 mg selama 3 bulan dibandingkan terhadap kelompok kontrol dengan terapi standar. Dilakukan pemeriksaaan global longitudinal strain (GLS) dengan speckle tracking echocardiography (STE) sebelum dan setelah terapi diberikan.Hasil: Total terdapat 41 pasien menyelesaikan penelitian (21 kelompok empagliflozin, 20 kelompok kontrol). Setelah 3 bulan follow up, nilai GLS kelompok empagliflozin cenderung tetap (rerata perubahan GLS 0,06%), sedangkan pada kelompok kontrol terdapat perburukan nilai GLS dengan rerata 1,5%, perbedaan kedua kelompok bermakna secara statistik (p 0,04). Kesimpulan: Terdapat perbedaan perubahan fungsi sistolik intrinsik ventrikel kiri setelah pemberian empagliflozin pada pasien diabetes melitus tipe 2 dengan gagal jantung dibandingkan terapi standar.

---

Background: Heart failure is a burden both in terms of prognostic and socio-economic. Heart failure and type 2 diabetes mellitus (T2DM) have a strong relationship in influencing patient s clinical outcome. Empagliflozin, an SGLT2 inhibitor, is a new antihyperlglycemic agent that has been shown to reduce mortality and hospitalization due to heart failure. Several mechanisms of cardioprotective effect of empagliflozin have been demonstrated in animal studies. Empagliflozin has proven to increase left ventricular systolic function in animal study. However, its effect on left ventricular intrinsic systolic function in T2DM patients with heart failure is unknown.

Objectives: Knowing the effect of empagliflozin on left ventricular intrinsic systolic function in T2DM patients with heart failure.

Methods: This is a randomized, open label, clinical trial, which was conducted at National Cardiovascular Center Harapan Kita (NCCHK) hospital outpatient clinic. The group who received 10 mg empagliflozin for 3 months was compared with control group. Global longitudinal strain (GLS) by speckle tracking echocardiography was examined before and after therapy was given.

Results: A total of 41 patients completed the study (21 in empagliflozin group, and 20 in control group). After 3 months of follow-up, the GLS in empagliflozin group remained constant (mean changes in GLS was 0.06%), whereas in the control group there was a deterioration in GLS with an average of 1.5%, the difference between the two groups was statistically significant (p 0.04).

Conclusion: There is a difference in left ventricular intrinsic systolic function after administration of empagliflozin in T2DM patients with heart failure compared to standard therapy."

"Peningkatan kasus diabetes melitus tipe 2 (DMT2) dengan berbagai komplikasinya memberikan dampak gangguan fungsional seseorang dalam bentuk gangguan kognitif dan kapasitas fisik. Keduanya masih reversibel dan baru diketahui berhubungan sehingga disebut sebagai PhysioCognitive Decline Syndrome (PCDS). Kondisi PCDS baru dipelajari pada lansia dan belum spesifik pada penyandang DMT2.TujuanMengetahui korelasi antara kendali glikemik dengan komponen physiocognitive decline syndrome pada penyandang DMT2 dewasa usia pertengahan.Metode Studi potong lintang menggunakan consecutive sampling dari pasien di poliklinik metabolik endokrin dan poli jantung terpadu sejak Januari 2021 – November 2022. Subjek DMT2 berusia 40 – 59 tahun diinklusi. Pemeriksaan kekuatan genggam tangan, dan kecepatan berjalan 6-meter diperiksakan di ruangan standar. MoCA-Ina dilakukan oleh dokter yang telah dilatih. Data HbA1c subjek yang diperiksa adalah HbA1c 3 bulan terakhir. Analisis korelasi Pearson’s atau Spearman’s pada SPSS 20.0 dilakukan sesuai sebaran data.Hasil Sebanyak 133 subjek telah dianalisis. Usia median mencapai 53 tahun dengan proporsi laki-laki dan perempuan serta komplikasi pada masing-masing kateori kendali glikemik (batas HbA1c 7,0%) serupa. Subjek didominasi dengan pendidikan SMA dan Sarjana/Diploma. Median durasi terdiagnosisnya diabetes melitus mencapai 7 tahun dengan HbA1c median 7.6%. Nilai MoCA-Ina pada subjek mencapai nilai median 24 dengan kecepatan berjalan rerata 1.02 + 0.23 m/detik dan median kekuatan genggam tangan 24 kg. Terdapat korelasi bermakna hanya pada HbA1c dengan kekutan genggam tangan (r = -0.24, R2 = 0.06, p value <0.01), terutama pada perempuanKesimpulanTerdapat korelasi bermakna antara kendali glikemik dan kekuatan genggam tangan.

---

Increasing cases of type 2 diabetes melitus (T2DM) including its complication have caused functional dysfunction consisted of cognitive decline and physical incapacity. Both cognitive decline and physical incapacity had been just known to be reversible and related to each other, so it is termed as PhysioCognitive Decline Syndrome (PCDS). However, it had been just evaluated in geriatric and not specific to T2DM patient.

To investigate the correlation between glycaemic correlation and component of physiocognitive decline syndrome in middle-aged adult with T2DM.

A cross sectional study with consecutive sampling in our metabolic and endocrine clinic and integrated heart centre in January 2021 – November 2022 had been conducted. Inclusion criteria was 40 – 59 years old subjects with T2DM. Measurement of HbA1c in the last 3 month were analysed, while hand grip strength and gait speed were done in standard room. MoCA-Ina had been conducted by trained doctor. Correlation analysis using Pearson’s or Spearman’s in SPSS 20.0 was done according to data distribution.

133 subjects were analysed. Median age was 53 years old with both sex and complication within each glycaemic control category (HbA1c 7,0% cut off) were similar. Subjects were dominated by high school and undergraduate/diploma education level. Most subjects were diagnosed in up to 7 years of T2DM. Median of HbA1c levels in our study was 7.6%. MoCA-Ina score was 24 in median with mean of gait speed was 1.02 + 0.23 m/s. Our median for hand grip was 24 kg. Significant correlation was only found in relationship of HbA1c and hand grip strength (r = -0.24, R2 = 0.06, p value <0.01).

There was significant correlation between glycaemic control and hand grip strength.

"