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Muttia Amalia
Abstrak :
Pendahuluan –Diabetes Mellitus tipe 2 (DMT2) merupakan sindrom inflamasi progresif dengan peningkatan risiko komplikasi kardiovaskular berupa Atherosclerotic Cardiovascular Disease (ASCVD). Proses thromboinflamasi pada DMT2 ASCVD dikaitkan dengan perubahan pada jumlah serta fungsi leukosit dan trombosit. Rasio leukosit (Neutrophil-Lymphocyte Ratio, Monocyte-Lymphocyte Ratio, Platelet-Lymphocyte Ratio) serta penanda biologis dari netrofil (Peptydil Arginine Deiminase-4), monosit/makrofag (Interleukin-6), dan trombosit (Platelet Glycoprotein 1b-α) dikenali sebagai penanda biologis yang dapat memprediksi perubahan plak stabil dan tidak stabil pada pasien DMT2 ASCVD. Studi ini dilakukan untuk menganalisis hubungan antara klasifikasi pasien DMT2 2 risiko sangat tinggi (Very High Risk / VHR) dan risiko tinggi (High Risk / HR) dan pada pasien DMT2 dengan Acute Coronary Syndrome (ACS) terhadap parameter inflamasi NLR, MLR, PLR, GPIbα, PAD4, dan IL-6. Metodologi – 75 pasien DMT2 ACSVD yang menjalani pengobatan di rawat jalan dan unit gawat darurat Rumah Sakit Pusat Jantung dan Pembuluh Darah Harapan Kita dilibatkan dalam studi ini. Pasien dikategorikan sebagai DMT2 risiko tinggi, DMT2 risiko sangat tinggi, dan DMT2 ACS. Parameter metabolisme dan inflamasi diukur dan dianalisis pada ketiga kelompok DMT2 ASCVD tersebut. Hasil dan Diskusi – Nilai parameter metabolisme kolesterol total dan Low Density Lipoprotein (LDL) serta parameter inflamasi NLR, MLR, PLR, dan IL-6 ditemukan lebih tinggi dan signifikan pada kelompok DMT2 ACS. Nilai Gp1bα ektodomain (Glikokalisin) ditemukan lebih tinggi pada kelompok DMT2 risiko tinggi dan DMT2 risiko sangat tinggi menggambarkan hubungan Gp1bα dan ADAM17 yang terkait dengan keseimbangan pembentukan dan pembersihan trombosit. Nilai PAD4 yang lebih tinggi pada kelompok DMT2 risiko tinggi dan DMT2 risiko sangat tinggi menggambarkan proses perbaikan jaringan dan induksi polarisasi makrofag menjadi fenotip antiinflamasi yang berperan terhadap perbaikan fungsi kardiovaskular. Penelitian ini menunjukkan bahwa nilai NLR dan kolesterol total yang tinggi serta nilai PAD4 yang rendah merupakan prediktor terjadinya keadaan ACS (plak tidak stabil) pada pasien DMT2 ASCVD. ......Introduction – Diabetes Mellitus type 2 (T2DM) is a progressive inflammatory syndrome with an increased risk of cardiovascular complications in the form of Atherosclerotic Cardiovascular Disease (ASCVD). The thromboinflammatory process in T2DM ASCVD is associated with changes in the number and function of leukocytes and platelets. The leukocyte ratio (Neutrophil-Lymphocyte Ratio, Monocyte-Lymphocyte Ratio, Platelet-Lymphocyte Ratio) as well as biological markers of neutrophils (Peptydyl Arginine Deiminase-4), monocytes/macrophages (Interleukin-6), and platelets (Platelet Glycoprotein 1b-α) are recognized as a biological marker that can predict stable and unstable plaque changes in T2DM with ASCVD. This study was conducted to analyze the relationship between the classification of T2DM patients with very high risk (VHR), high risk (HR), and early onset ACS on the inflammatory parameters NLR, MLR, PLR, GPIbα, PAD4, and IL-6. Methodology – This study included 75 ACSVD T2DM patients being treated at Harapan Kita Heart and Blood Vessel Center Hospital's outpatien and emergency unit. Patients were classified as having high risk T2DM, extremely high risk T2DM, or ACS T2DM. In the three T2DM ASCVD groups, metabolic and inflammatory parameters were evaluated and studied. Results and Discussion – The metabolic indices total cholesterol and Low Density Lipoprotein (LDL), as well as the inflammatory markers NLR, MLR, PLR, and IL-6, were shown to be greater and significant in the T2DM ACS group. Gp1b ectodomain (Glycocalysin) values were found to be greater in the high risk T2DM and very high risk T2DM groups, demonstrating the relationship between Gp1b and ADAM17, which is associated to platelet production and clearance balance. Higher PAD4 values in the high risk T2DM and very high risk T2DM groups represent tissue repair and the activation of macrophage polarization into an anti-inflammatory phenotype, which contributes to improved cardiovascular function. According to this study, high NLR and total cholesterol levels, as well as low PAD4 levels, are predictors of ACS (unstable plaque) in ASCVD T2DM patients.
Depok: Fakultas Farmasi Universitas Indonesia, 2024
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UI - Disertasi Membership  Universitas Indonesia Library
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Sigit Mohammad Nuzul
Abstrak :
Tingginya prevalensi diabetes mellitus tipe 2 dan makanan khas daerah yang mengandung cukup banyak lemak menyebabkan peningkatan resiko peripheral arterial disease di Kota Palu. Latihan Buerger Allen merupakan salah satu cara mencegah dan mengatasi penyakit ini. Akan tetapi, latihan tersebut kurang digunakan karena belum adanya penelitian terkait latihan ini yang dipublikasikan di Indonesia. Penelitian ini bertujuan untuk mengetahui pengaruh latihan ini terhadap sirkulasi perifer pada ekstremitas bawah pasien diabetes mellitus tipe 2. Penelitian ini merupakan quasi-experimental, model pretest?posttest nonequivalent control group dengan 24 responden. Latihan ini diberikan kepada kelompok perlakuan selama 4 hari, 3 kali sehari, 2 siklus latihan selama 22 menit. Hasil uji statistik menunjukkan ada perbedaan bermakna nilai ankle brachial index antara pretest dan posttest pada kelompok perlakuan (p = .047; α .05), sebaliknya tidak ada perbedaan yang bermakna pada kelompok kontrol (p = .083; α .05). Secara statistik disimpulkan bahwa ada perbedaan bermakna antara nilai ankle brachial index posttest kelompok perlakuan dengan kontrol (p = .045; α .05), sehingga disimpulkan latihan ini efektif meningkatkan sirkulasi arteri perifer ekstremitas bawah. Disarankan agar latihan ini diberikan kepada pasien diabetes mellitus tipe 2.
Patient with diabetes mellitus have high risk of peripheral arterial disease. The risk increased on Palu City due to high prevalence of diabetes mellitus type 2 and food culture with high amount of fats. The Buerger-Allen exercise studies showed positive effect to improve lower extremity perfusion among patients with type 2 diabetes mellitus. However, this exercise gradually has been dropped in recent decades due to lack of published study in Indonesia. The study aimed to identify the effectiveness of this exercise to improve peripheral circulation of lower extremity. This study is the quasi-experimental with a pretest-posttest nonequivalent control group model, which enrolled 12 experimental and 12 control participants. Exercise had provided for 4 days, 3 times a day, and 2 cycles exercise for 22 minutes. The result showed significant difference of ankle-brachial index between the experiment and control group (p = .045; α .05). This study recommends Buerger-Allen exercise to be applied to patients with type 2 diabetes mellitus.
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2016
S64606
UI - Skripsi Membership  Universitas Indonesia Library
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Ardhona Irani
Abstrak :
Glikosaminoglikan merupakan komponen penyusun glikokaliks yang berperan penting dalam per selektivitas muatan anionik kapiler glomerulus. Gangguan hemodinamik dan metabolik akibat hiperglikemia kronis menyebabkan peluruhan komponen glikokaliks endotel. Beberapa pedoman telah menyetujui keamanan tiap OAD berdasarkan fungsi ginjal. Tujuan penelitian adalah menilai keamanan penggunaan metformin (metformin dan metformin-glimepirid) berdasarkan fungsi ginjalnya serta menilai perbandingan kadar GAG urin pasien DMT 2 kelompok risiko rendah terhadap risiko sedang-tinggi PGK. Desain penelitian potong lintang dan metode consecutive di Puskesmas Depok Jaya dan Kecamatan Pasar Minggu. Sampel urin dan darah dikumpulkan untuk pengukuran eLFG, HbA1c, ACR, dan kadar GAG urin. Sebanyak 137 partisipan dinilai keamanan penggunaan metformin berdasarkan fungsi ginjalnya. Terdapat ketidaksesuaian pada 1 partisipan dalam penggunaan metformin (n=55) dan semua partisipan (n=82) sesuai dengan pedoman dalam penggunaan metformin-glimepirid. Hanya 121 partisipan yang dianalisis kadar GAG urin menggunakan 1,9-DMMB dan terdiri dari 4 yaitu kelompok risiko rendah PGK: G1-A1(eLFG ≥90ml/min/1,73m² - <30mg/g) (n=25) dan G2-A1(eLFG 60-89ml/min/1,73m² - <30mg/g) (n=45) serta risiko sedang-tinggi PGK: GI-A2(eLFG ≥ 90ml/menit/1,73m² - >30mg/g) (n=23) dan G2-A2(eLFG 60-89ml/menit/1,73m² - >30mg/g) (n=28). Tidak ada perbedaan bermakna (p<0,05) pada karakteristik dasar dan klinis keempat kelompok kecuali usia (p=0,006) dan HbA1c (p<0,001). Tidak terdapat perbedaan kadar GAG urin yang bermakna antara kelompok G1 dengan G2 (p=0,290) serta pada keempat kelompok (p=0,221). Terdapat perbedaan kadar GAG urin yang bermakna (p=0,034) pada kelompok normoalbuminuria dan albuminuria. Faktor lain seperti durasi DMT 2 >5 tahun dan komorbiditas dapat meningkatkan kadar GAG urin. Oleh karena itu, diperlukan studi lanjut mengenai potensi GAG urin pada awal perkembangan penyakit ginjal diabetes. ......Glycosaminoglycans are components of the glycocalyx which play an important role in the permeselectivity of the anionic charge of the glomerular capillaries. Hemodynamic and metabolic disturbances due to chronic hyperglycemia cause the breakdown of the glycocalyx component of the endothelium. Several guidelines have agreed on the safety of each OAD based on renal function. The aims of this study were to assess the safety of using metformin (metformin and metformin-glimepiride) based on kidney function and to evaluate the comparison of urinary GAG levels in patients with DMT 2 in low-risk groups to moderate-high risk of CKD. Cross-sectional research design and consecutive in Depok Jaya Public Health Center and Pasar Minggu District. Urine and blood samples were collected for measurement of eGFR, HbA1c, ACR, and urinary GAG levels. A total of 137 participants assessed the safety of using metformin based on their kidney function. There was a discrepancy in 1 participant in the use of metformin (n=55) and all participants (n=82) according to the guidelines for the use of metformin-glimepiride. Only 121 participants were analyzed for urine GAG ​​levels using 1,9-DMMB and consisted of 4 low risk groups for CKD: G1-A1(eGFR 90ml/min/1.73m² - <30mg/g) (n=25) and G2-A1(eGFR 60-89ml/min/1.73m² - <30mg/g) (n=45) and moderate-high risk of CKD: GI-A2(eGFR 90ml/min/1.73m² - >30mg/g) (n=23) and G2-A2(eLFG 60-89ml/min/1.73m² - >30mg/g) (n=28). There was no significant difference (p<0.05) in the baseline and clinical characteristics of the four groups except age (p=0.006) and HbA1c (p<0.001). There was no significant difference in urine GAG ​​levels between the groups G1 with G2 (p= 0.290) and in the four groups (p= 0.221). There was a significant difference in urine GAG ​​levels (p= 0.034) in the normoalbuminuria and albuminuria groups. Other factors such as duration of DMT 2 > 5 years and comorbidities can increase urinary GAG levels. Therefore, further studies are needed regarding the potential of urinary GAGs in the early development of diabetic kidney disease.
Depok: Fakultas Farmasi Universitas Indonesia, 2022
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UI - Skripsi Membership  Universitas Indonesia Library
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Sri Fitria Wahyuni
Abstrak :
Diabetes Mellitus tipe-2 (DM tipe-2) merupakan suatu kelainan yang ditandai dengan adanya resistensi insulin. Salah satu faktor risiko DM tipe-2 pada otot rangka yakni terjadi penurunan massa otot rangka yang disebabkan oleh degradasi protein otot yang berlebihan. Jalur degradasi otot rangka diregulasi 2 sistem yakni ubiquitin proteosom dan autofagi. Terdapat faktor transkripsi pada ubiquitin proteosom yakni KLF15. Sedangkan pada autofagi terdapat P62 sebagai protein multifungsi. Pada kondisi DM, peran 2 biomarker ini belum sepenuhnya diketahui dalam pengaturan degradasi otot. Dimasa ini, terdapat suatu intervensi yang populer dan terbukti efektif untuk homeostasis otot rangka yakni High Intensity Interval Training (HIIT). Tipe latihan ini menggabungkan latihan berintensitas tinggi dengan periode istirahat berinterval. Pengaruh HIIT terhadap DM pada jalur degradasi masih harus dikaji lebih lanjut. Pada penelitian ini diberikan perlakuan HIIT selama 6 minggu pada tikus yang dbuat DM tipe-2 dibandingkan dengan kelompok DM tanpa perlakuan dan kelompok kontrol dengan melihat perubahan massa otot gastroknemius yang ditinjau dengan menimbang massa otot gastrocnemius yang didekapitasi. Ekspresi KLF15 dianalisis menggunakan qRT-PCR dan p62 menggunakan western blot. Hasil data statistik menunjukkan bahwa tidak ada perbedaan signifikan pada peningkatan massa otot, tidak ada perbedaan signifikan pada peningkatan ekspresi relatif KLF15 dan tidak ada perbedaan signifikan pada penurunan p62 pada perlakuan HIIT terhadap DM tipe-2. ......Type-2 Diabetes Mellitus (Type-2 DM) is a disorder characterized by insulin resistance. One of the risk factors for type-2 DM in skeletal muscle is a decrease in skeletal muscle mass caused by excessive degradation of muscle protein. Skeletal muscle degradation pathway is regulated by 2 systems namely ubiquitin proteosome and autophagy. There is a transcription factor in the proteosome ubiquitin, namely KLF15. Whereas in autophagy there is P62 as a multifunctional protein. In DM conditions, the role of these 2 biomarkers is not fully understood in regulating muscle degradation. At this time, there is an intervention that is popular and proven effective for skeletal muscle homeostasis, namely High Intensity Interval Training (HIIT). This type of exercise combines high-intensity exercise with intermittent rest periods. The effect of HIIT on DM in the degradation pathway still needs to be studied further. In this study, rats treated with HIIT for 6 weeks were given type-2 DM compared to the DM group without treatment and the control group by looking at changes in gastrocnemius muscle mass which was reviewed by weighing the mass of the decapitated gastrocnemius muscles. KLF15 expression was analyzed using qRT-PCR and p62 using western blot. The results of the statistical data showed that there was no significant difference in increasing muscle mass, there was no significant difference in increasing the relative expression of KLF15 and there was no significant difference in decreasing p62 in the HIIT treatment of type-2 DM.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tesis Membership  Universitas Indonesia Library
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Nani Cahyani Sudarsono
Abstrak :
ABSTRAK
Program latihan untuk penatalaksanaan Diabetes Melitus DM tipe 2 harus dipastikan aspek keamanannya, selain juga efektif dan bermanfaat. Melalui penelitian dua tahap dilakukan perancangan latihan fisik yang dievaluasi dengan randomized controlled trial RCT .Program latihan 12 minggu mengombinasikan high intensity interval training HIIT dan latihan beban tiga dan dua kali per minggu dengan peningkatan intensitas bertahap. HIIT terdiri atas perbandingan 1 : 4 menit high intensity exercise HIE dan low intensity exercise LIE . Latihan beban terdiri atas sembilan latihan untuk batang tubuh, ekstremitas atas, dan bawah. RCT diikuti 42 penyandang DM tipe 2 berusia 35 ndash;64 tahun, yang dialokasikan menjadi kelompok eksperimen dengan latihan sesuai rancangan dan kelompok kontrol dengan continuous cardiorespiratory training. Pemeriksaan tingkat kebugaran VO2max , kontrol glikemik HbA1c , dan stres oksidatif MDA dan SOD dilakukan di awal dan akhir program.Pasca latihan didapatkan nilai rerata VO2max kelompok eksperimen 38,13 5,93 mL/kg.min lebih tinggi dibandingkan kontrol 32,09 5,24 mL/kg.min , p = 0,004, serta stres oksidatif menurun MDA eksperimen ? -0,14 0,39 nmol/mL dibandingkan kontrol ? 0,18 0,26 nmol/mL , p = 0,011; SOD eksperimen median ? 0,47 U/mL IQR 0,08-0,74 U/mL dibandingkan kontrol ? 0,14 0,35 U/mL , p = 0,036 . HbA1c kelompok eksperimen menunjukkan penurunan ? -0.43 1.01 , namun tidak bermakna. Skor komposit efek latihan lebih tinggi pada kelompok eksperimen 8,72 1,27 dibandingkan kontrol 7,20 1,08 , p = 0,001.Dengan demikian disimpulkan bahwa program latihan pada penelitian ini memberi manfaat dan dapat diimplementasikan dengan aman. Kata kunci: HIIT dan latihan beban; program latihan berbasis pasien; stres oksidatif; T2DM
ABSTRACT
Exercise programs for patients with Type 2 Diabetes Mellitus T2DM must be demonstrably safe, effective, and beneficial. Objectives. In this two-step study, a training program was designed and implemented in a randomized controlled trial RCT to meet the above criteria.The 12-week exercise program combined high intensity interval training HIIT three times per week and resistance training twice weekly , with gradually increased intensity. The HIIT element comprised 1 minute of high intensity exercise HIE and 4 minutes of low intensity exercise LIE . The resistance training element comprised nine exercises for core, upper, and lower extremities. The 42 T2DM patients who participated in the RCT were aged 35 ndash;64 years. Participants were randomly allocated to the experimental EXP group for the new training program and to the control KTR group for continuous cardiorespiratory training. Fitness level VO2max , glycemic control HbA1c , and oxidative stress MDA and SOD were measured before and after the exercise program.VO2max was higher in EXP 38.13 5.93 mL/kg.min than in KTR 32.09 5.24 mL/kg.min; p = 0.004 . Overall oxidative stress decreased in EXP MDA EXP ? -0.14 0.39 nmol/mL as compared to KTR ? 0.18 0.26 nmol/mL; p = 0.011 and SOD EXP median ? 0.47 U/mL IQR 0.08-0.74 U/mL as compared to KTR ? 0.14 0.35 U/mL; p = 0.036 . EXP HbA1c also decreased, although not significantly ? -0.43 1.01 . EXP composite effects score was significantly higher 8.72 1.27 than for KTR 7.20 1.08; p = 0.001 .The exercise program for T2DM patients was shown to be safe, with significant benefits.Keywords: glycemic control; HIIT and resistance training; oxidative stress; patient-based training program; physical fitness; T2DM
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Disertasi Membership  Universitas Indonesia Library
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Latifatul Khoiriyah
Abstrak :
Latar belakang: Diabetes melitus tipe 2 masih menjadi masalah kesehatan global yang serius. Prevalensi DMT2 selalu meningkat dari tahun 2000-2021 yakni dari 4,55% menjadi 10,6%. Angka kematian DMT2 juga mengalami peningkatan sebanyak 57,94% dari tahun 2011 ke tahun 2021. Walaupun pemerintah sudah berupaya dalam mengendalikan DMT2, beban penyakit ini diproyeksikan meningkat hingga tahun 2045. DMT2 merupakan penyakit dengan angka mortalitas dan morbiditas yang tinggi. Beban penyakit DMT2 ini dapat tercermin dalam ukuran DALYs. Penelitian ini bertujuan untuk melihat tren DALYs penyakit DMT2 dan faktor risikonya di Indonesia tahun 1990-2021. Metode: Penelitian ini menggunakan metode systematic review dengan data sekunder Global Burden of Disease 2021. Populasi dari penelitian ini adalan penduduk usia ≥ 35 tahun di 34 provinsi di Indonesia dengan unit analisis provinsi. Variabel dalam penelitian ini adalah DALYs DMT2, DALYs DMT2 akibat IMT tinggi, dan DALYs DMT2 akibat perilaku merokok. Hasil: Penelitian menjukkan DALYs DMT2 mengalami kenaikan sebesar 59,6% dari tahun 1990-2021. Faktor yang paling berkontribusi dalam DALYs DMT2pada tahun 2021 yaitu IMT tinggi (41,7%) dan perilaku merokok (15,8%). DALYs DMT2 yang disebabkan oleh faktor risiko tersebut juga mengalami kenaikan, dengan rincian 133,21% untuk IMT tinggi dan 69,2% untuk perilaku merokok. Kesimpulan: DALYs DMT2, DALYs DMT2 akibat IMT tinggi, dan DALYs DMT2 akibat perilaku merokok selalu meningkat dari tahun 1990-2021. Hal ini menunjukkan kewaspadaan masyarakat terhadap dampak DMT2 yang masih rendah. ......Background: Type 2 diabetes mellitus remains a serious global health problem. The prevalence of T2DM has always increased from 2000-2021, from 4.55% to 10.6%. The mortality rate of T2DM also increased by 57.94% from 2011 to 2021. Despite the government's efforts to control T2DM, the disease burden is projected to increase until 2045. T2DM is a disease with high mortality and morbidity. The disease burden of T2DM can be reflected in the DALYs measure. This study aims to examine the trend of T2DM disease DALYs and its risk factors in Indonesia from 1990 to 2021. Methods: This study used systematic review methods with secondary data from the Global Burden of Disease 2021. The population of this study was the population aged ≥ 35 years in 34 provinces in Indonesia. The variables in this study were T2DM DALYs, T2DM DALYs due to high BMI, and T2DM DALYs due to smoking behaviour. Results: The study showed that T2DM DALYs increased by 59.6% from 1990- 2021. The most contributing factors to T2DM DALYs in 2021 were high BMI (41.7%) and smoking behaviour (15.8%). T2DM DALYs caused by these risk factors also increased, with 133.21% for high BMI and 69.2% for smoking behaviour. Conclusion: T2DM DALYs, T2DM DALYs due to high BMI, and T2DM DALYs due to smoking behaviour always increased from 1990-2021. This shows that public awareness of the impact of T2DM is still low.
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2024
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UI - Skripsi Membership  Universitas Indonesia Library
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Fanny Mustikaningtyas
Abstrak :
ABSTRAK
Diabetes Melitus merupakan penyakit tidak menular penyebab kematian terbesar keempat di dunia. Depok menduduki peringkat 2 di Jawa Barat dengan jumlah penderita diabetes mellitus tipe 2 terbanyak. Insulin direkomendasikan sebagai salah satu terapi diabetes lini pertama untuk mengontrol kadar glukosa. Oleh karena itu, penting untuk mengetahui tingkat kepatuhan terapi insulin pada penderita diabetes mellitus tipe 2 agar tercapai hasil terapi sesuai dengan yang direncanakan. Penelitian ini bertujuan untuk mengidentifikasi gambaran kepatuhan terapi insulin pada penderita diabetes mellitus tipe 2 di Kota Depok. Penelitian ini merupakan penelitian kuantitatif dengan menggunakan desain penelitian model cross sectional dan menggunakan teknik consecutive sampling sebagai teknik dalam pengambilan sampel. Jumlah sampel 79 orang pasien diabetes mellitus tipe 2 yang berobat ke Rumah Sakit Umum Daerah Kota Depok. Berdasarkan hasil penelitian didapatkan kepatuhan insulin masih rendah sebanyak 52 orang 65,8 . Adanya penelitian ini, diharapkan dapat memberikan informasi kepada Rumah Sakit Umum Daerah Kota Depok, Dinas Kesehatan Depok, perawat, dan masyarakat untuk meningkatkan kepatuhan terapi insulin.
ABSTRAK
Abstract Diabetes Mellitus is the fourth leading non infectious diseases cause of death in the world. Depok was ranked 2nd in West Java with the highest number of people with type 2 diabetes mellitus. Insulin is recommended as one of the first line diabetes therapy to control glucose levels. Therefore, it is important to know the adherence level of insulin therapy in people with type 2 diabetes mellitus in order to achieve the satisfied results of therapy. This study aimed to identify the level of adherence in insulin therapy among people with type 2 diabetes mellitus in Depok City. This research was a quantitative research using a cross sectional design and using consecutive sampling as a technique in sampling. The number of samples were 79 patients with type 2 diabetes mellitus who came to the Regional General Hospital of Depok City. The result showed that the level of insulin adherence came still low as many as 52 people 65.8 . This study is expected to provide information to the Regional General Hospital of Depok City, Depok Health Office, nurses, and the community to improve adherence to insulin therapy.
2017
S67065
UI - Skripsi Membership  Universitas Indonesia Library
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Rahmi Safyanty
Abstrak :
ABSTRAK ABSTRACT
Fasting Ramadan is a mandatory worship of Muslims including patients type-2 Diabetes Mellitus (DM). Dietary changes during fasting cause a drug adjustment is needed so that DM patients can fast safely. This study looked at the correlation of drug adjustment based on International Diabetes Federation - Diabetes and Ramadhan International Alliance (IDF-DAR) and HbA1c value of type 2 DM patient after Ramadan fasting at RSUD Pasar Rebo Jakarta. The study was conducted in outpatient clinic of Pasar Rebo Hospital Jakarta with cross-sectional study design involving 80 patients with fasting type 2 diabetes. The study aimed to see the use of DM drugs during fasting, assessed the relation of drug adjustment based on IDF-DAR and confounding factors and the HbA1c values of patients after fasting. Data collection from interview and medical record conducted in July until November 2016 and analyzed by Chi-Square test. The results showed that the patients with Type-2 DM who execute Ramadan fasting, the largest percentage of medication adherence 62.5% , using oral medication by 60% of the biguanide + sulfonylurea 27.5% and 56,2% drug adjustment according to IDF-DAR recommendations. The mean HbA1c value before the drug adjustment was 8.75 ± 1.90 and after adjustment 8.63 ± 1.82 but the reduction was not statistically significant (p 0.082). There was a significant difference in HbA1c value of DM patients after obtaining drug use adjustment based on IDF-DAR compared with IDF-DAR incompatible with p value 0,030 (p <0,05). Discrepancy of drug use based on IDF-DAR 3,222 times greater causes uncontrolled HbA1c compared with drug use according to IDF-DAR. The drug type is the main statistically significant variable that gives effect to HbA1c value (p 0,050). Insulin-combination insulin drugs are 3,754 times larger causing the HbA1c value to be uncontrolled than oral medication after controlled by the suitability of drug use based on IDF-DAR variable.
2018
T49012
UI - Tesis Membership  Universitas Indonesia Library
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Silma Kaaffah
Abstrak :
ABSTRAK
Penelitian terkait evaluasi perilaku berobat penderita diabetes melitus (DM) tipe 2 terhadap penurunan parameter glikemik di Indonesia dengan big data skala nasional masih sangat terbatas. Tujuan penelitia mengevaluasi perilaku berobat penderita DM tipe 2 terhadap penurunan parameter glikemik ( kadar gula darah puasa (GDP) dan gula darah 2 jam pasca pembebanan (GDPP)). Metode penelitian kohor retrospektif menggunakan subset data sekunder Studi Kohor Bogor dengan membandingkan proporsi kelompok perilaku berobat dan kelompok perilaku tidak berobat terhadap penurunan parameter glikemik. Pengambilan subset data bulan Agustus 2019, didapatkan sampel responden dengan pemantauan 4 tahun, kelompok berobat 62 dan kelompok tidak berobat 105 responden. Hasil penelitian, proporsi penurunan parameter glikemik  kelompok berobat lebih besar (GDP 80,6% dan GD2PP 90,3%) dibandingkan kelompok tidak berobat (GDP 42,0% dan GD2PP 67,3%). Terdapat perbedaan signifikan penurunan kadar GDP dan GDPP kelompok berobat dan tidak berobat (nilai p <0,05). Perilaku berobat meningkatkan kejadian penurunan kadar GDP selama 4 tahun sebesar 3,304 kali dibandingkan perilaku tidak berobat, setelah dikontrol oleh variabel penurunan kadar LDL dan penggunaan obat tablet. Perilaku berobat meningkatkan kejadian penurunan kadar GDPP selama 4 tahun sebesar 3,064 kali dibandingkan perilaku tidak berobat, setelah dikontrol oleh variabel penggunaan obat tablet, penurunan kadar LDL dan aktifitas fisik yang cukup.
ABSTRACT
Research related to the evaluation of the treatment behavior of people with diabetes mellitus (DM) type 2 on the decrease in glycemic parameters in Indonesia with a national big data scale is still very limited. The purpose of this study is to evaluate the treatment behavior of patients with type 2 diabetes against glycemic parameters (fasting plasma glucose  (FPG) and post prandial glucose (PPG)). The retrospective cohort study method uses a secondary data subset of the Bogor Cohort Study by comparing the proportions of the treatment behavior group and the non-treatment behavior group to decrease glycemic parameters. Taking a subset of data in August 2019, obtained a sample of respondents with 4 years of monitoring, 62 treatment groups and 105 respondent non-treatment groups. The results of the study, the proportion of the decrease in glycemic parameters of the treatment group was greater (FPG 80.6% and PPG 90.3%) compared to the group without treatment (FPG 42.0% and PPG 67.3%). There was a significant difference in the decrease in levels of FPG and PPG in the treatment and non-treatment groups (p value <0.05). Behavior of treatment increases the incidence of decreasing levels of GDP for 4 years by 3,304 times compared to non-treatment behavior, after being controlled by the variable decrease in LDL levels and the use of tablet drugs. Behavior of treatment increases the incidence of decreasing levels of GDPP for 4 years by 3.064 times compared to the behavior of no treatment, after being controlled by the variable drug use of tablets, decreased levels of LDL and sufficient physical activity.
2019
T54834
UI - Tesis Membership  Universitas Indonesia Library
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Muhammad Nizar Hamzah Al Faris
Abstrak :
Propolis merupakan senyawa resin yang dikumpulkan dan diolah oleh lebah madu dari berbagai macam sumber tanaman dan banyak digunakan sebagai obat tradisional. Propolis tersusun atas komponen yang bervariasi serta memiliki aktivitas biologis yang luas dimana salah satunya adalah aktivitas anti-diabetes. Diabetes melitus merupakan penyakit metabolik di seluruh dunia yang diindikasikan oleh hiperglikemia atau tingginya kadar gula darah. Penyakit ini disebabkan oleh defisiensi sekresi insulin, resistansi enzim insulin, atau kerusakan. Diantara klasifikasi diabetes melitus, tipe 2 adalah kasus paling banyak dengan proporsi 90 - 95% dari total kasus diabetes. Sayangnya, obat diabetes melitus komersial saat ini masih menghasilkan banyak efek samping yang berbahaya. Pada aktivitas antidiabetes propolis, penelitian umum yang dilakukan membahas nilai kritis seperti gula darah, HbA1c, dan berat badan subjek penelitian. Disisi lain, penelitian yang menjawab aktivitas antidiabetes masih terbatas pada struktur atau kelas senyawa kimia tertentu seperti pada flavonoid, steroid, dan isoflavonoid. Pada penelitian ini akan dilakukan pengujian aktivitas antidiabetes tipe 2 dari propolis secara in silico dan mempelajari mekanismenya pada tubuh manusia. Sebagai bentuk kebaruan, akan menggunakan 30 senyawa uji yang berasal dari dua kelompok propolis Sulawesi Selatan yaitu hasil penelusuran menggunakan LC-MS / MS dan berdasarkan publikasi Miyata et al. (2020). Penelitian ini diawali dengan penentuan target protein yang meregulasi diabetes melitus tipe 2. Kemudian persiapan bahan dilakukan untuk masing-masing ligan dan target protein. Selanjutnya dilakukan analisis penambatan molekuler, analisis interaksi molekuler, visualisasi 2D dan 3D. Berdasarkan hasil analisis, aktivitas antidiabetes tipe 2 diperoleh dari senyawa 1,2,2-Trimethyl-3 - [(4-methylphenyl) carbamoyl] cyclopentane carboxylic acid dengan menginhibisi Aldose Reductase, Macarangin dengan mengaktivasi NAD-Dependent protein deacetylase sirtuin-6, (1'S) -2-trans, 4-trans-absisic acid dengan menginhibisi Dipeptidyl Peptidase 4, serta Broussoflavonol F dan Glyasperin A dengan menginhibisi Fructose-1,6-bisphosphatase. Dari hasil analisis pada penelitian ini ditunjukkan bahwa aktivitas antidiabetes dari propolis sulawesi selatan terbukti pada skala atomik. ......Propolis is a resin compound which is collected and processed by honey bees from various plant sources and is widely used as traditional medicine. Propolis is composed of various components and has extensive biological activity, one of which is anti-diabetic activity. Diabetes mellitus is a metabolic disease throughout the world that is indicated by hyperglycemia or high blood sugar levels. This disease is generally caused by deficiency of insulin secretion, insulin enzyme resistance, or both. Among the classification of diabetes mellitus, type 2 is the most cases with a percentage of 90 - 95% of the total diabetes cases. In antidiabetic activity of propolis, research is generally conducted to discuss critical values ​​such as blood glucose, HbA1c, and body weight of research subjects. Unfortunately, current diabetes mellitus therapy still produces many dangerous side effects. On the other hand, research that answers the mechanism of antidiabetic activity is still limited to the structure or class of certain chemical compounds such as flavonoids, steroids, and isoflavonoids. This research will evaluate type 2 antidiabetic activity of propolis in silico and study its mechanism in the human body. As a form of novelty, 30 molecules derived from two groups of South Sulawesi propolis, namely results of LC-MS / MS identification and based on the publication of Miyata et al. (2020). The research begins with the determination of target proteins which regulate type 2 diabetes mellitus. Then material preparation was carried out for each ligand and target protein. Furthermore, molecular docking analysis, molecular interaction analysis, 2D and 3D visualization were performed. Based on the analysis, type 2 antidiabetic activity was obtained from 1,2,2-Trimethyl-3 - [(4-methylphenyl) carbamoyl] cyclopentane carboxylic acid with the mechanism of inhibiting Aldose Reductase, Macarangin by activating the NAD-Dependent protein deacetylase sirtuin-6, (1'S) -2-trans, 4-trans-abscisic acid with the mechanism of inhibiting Dipeptidyl Peptidase 4, and Broussoflavonol F and Glyasperin A with the mechanism of inhibiting Fructose-1,6-bisphosphatase. From the results of the analysis in this study it was shown that the antidiabetic activity of South Sulawesi propolis was proven on the atomic scale.
Depok: Fakultas Teknik Universitas Indonesia, 2020
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