scholarly journals 102 Jurnal Kesehatan Andalas. 2015; 4(1) Pola Komplikasi Kronis Penderita Diabetes Melitus Tipe 2 Rawat Inap di Bagian Penyakit Dalam RS. Dr. M. Djamil Padang Januari 2011 - Desember 2012

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Dwi Amelisa Edwina ◽  
Asman Manaf ◽  
Efrida Efrida

AbstrakDiabetes Melitus (DM) merupakan suatu kelompok penyakit metabolik dengan karakteristik hiperglikemia. DM tipe 2 adalah yang paling sering ditemukan. Komplikasi kronis DM tipe 2 yaitu mikrovaskular dan makrovaskular yang dapat menurunkan kualitas hidup penderita. Tujuan penelitian ini adalah untuk memperoleh gambaran tentang insidensi penderita DM tipe 2 dengan komplikasi kronis. Penelitian deskriptif ini dilakukan dengan mengambil data pada rekam medik penderita DM tipe 2 dengan komplikasi kronis yang dirawat inap di bagian Penyakit Dalam RS.Dr. M. Djamil, Padang Januari 2011-Desember 2012. Penelitian dilakukan dari Februari 2013-April 2013 di bagian rekam medik RS. Dr. M. Djamil Padang. Data didapatkan sebanyak 261 pasien, dari jumlah tersebut didapatkan 197 pasien memiliki komplikasi kronis DM tipe 2. Data dikategorikan berdasarkan jenis komplikasi makrovaskular dan mikrovaskular. Hasil penelitian menunjukkan bahwa penderita dengan komplikasi kronis makrovaskular (66,5%) dan mikrovaskular (81,7%). Terdapat perubahan insidensi dalam dua tahun yaitu dari tahun 2011 dengan 2012. Komplikasi kronis yang paling sering terjadi adalah nefropati diabetik (42,6%) pada perempuan <60 tahun.Kata kunci: diabetes melitus, komplikasi mikrovaskular, komplikasi makrovaskularAbstractDiabetes mellitus is a group of metabolic diseases with characterized by hyperglycemia. Type 2 diabetes is the most common disease in the world. Chronic complications of type 2 diabetes are microvascular and macrovascular complications that can reduce the quality of life of patients. The objective of this study was to obtain a picture of the incidence of type 2 diabetic chronic complications. This descriptive study was conducted by taking medical record data of hospitalized type 2 diabetic patients with chronic complications inInternal Medicine Department Dr. M. Djamil hospital, Padang on January 2011-December 2012. The study was conducted from February 2013-April 2013 at the hospital medical record Dr. M. Djamil, Padang. This study was conducted on 261 patients, from that number 197 patients have chronic complications of type 2 diabetes mellitus. Data were categorized by type of macrovascular and microvascular complications.The results showed that patients with chronic complications of macrovascular (66,5%) and microvascular (81,7%). There is a change in incidence from 2011 to 2012. The most common of chronic complications is diabetic nephropathy (42.6%). Chronic microvascular and macrovascular complications are different incidence in two years, the most common is diabetic nephropathy which often occurs in women <60 years.Keyword: diabetes mellitus, microvascular complication, macrovacular complication.

2017 ◽  
Vol 4 (1) ◽  
pp. 16
Author(s):  
Tities Anggraeni Indra ◽  
Aida Lydia ◽  
Dyah Purnamasari ◽  
Siti Setiati

Pendahuluan. Angka kejadian nefropati diabetik di Indonesia dilaporkan meningkat. Defisiensi vitamin D juga cukup tinggi. Berbagai faktor telah diidentifikasi turut memperberat kejadian nefropati diabetik salah satunya status vitamin D 25(OH)D. Namun demikian, bekum ada studi yang mengidentifikasi hubungan keduanya di Indonesia. Penelitian ini bertujuan untuk mengetahui asosiasi antara status vitamin D 25(OH)D dengan albuminuria pada pasien diabetes melitus tipe 2 di Indonesia.Metode. Dilakukan studi potong lintang pada 96 pasien diabetes melitus (DM) tipe 2 yang berobat ke poliklinik MetabolikEndokrin Fakultas Kedokteran Universitas Indonesia/Rumah Sakit dr. Cipto Mangunkusumo (FKUI/RSCM), Jakarta pada November-Desember 2012. Pemeriksaan kadar vitamin D 25(OH)D diilakukan dengan menggunakan kit Diasorin dengan metode CLIA, sedangkan albuminuria dinilai berdasarkan kadar albumin pada sampel urin sewaktu. Uji statistik yang digunakan meliputi uji chi square pada analisis bivariat dan regresi logistik pada analisis multivariat.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 adalah 16,35 (4,2-41,4) ng/mL. Tidak didapatkan adanya hubungan yang bermakna secara statistik antara defisiensi vitamin D dengan albuminuria, baik pada analisis bivariat maupun multivariat (OR 0,887; IK95% 0,3352,296). Faktor perancu yang memengaruhi hubungan antara defisiensi vitamin D dengan kejadian albuminuria pada pasien DM tipe 2 adalah kontrol gula darah yang buruk dan berat badan lebih.Simpulan. Studi ini belum dapat menyimpulkan adanya hubungan antara defisiensi vitamin D 25(OH)D dengan albuminuria pada pasien DM tipe 2 di Indonesia.Kata Kunci: albuminuria, defisiensi vitamin D 25(OH)D, DM tipe 2  The Association between Vitamin D 25(OH)D Level and Albuminuria in Type 2 Diabetes MellitusIntroduction. Vitamin D 25(OH)D deficiency was reported as a possible risk factor for the development of diabetic nephropathy in several epidemiologic studies. Whether vitamin D 25(OH)D deficiency plays a role in the development of diabetic nephropathy in Indonesia is unknown. This study aims to determinate 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 MetabolicEndocrine Cipto Mangunkusumo Hospital. Serum vitamin D level was assessed using Diasorin kit with CLIA method, while albuminuria was assessed using random urine sample. Statistical analysis was conducted using chi square for bivariate analysis and regression logistic method for multivariate analysis. 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 (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 showed that there was no association between vitamin D deficiency with the severity of albuminuria in patients with type 2 diabetes mellitus in Indonesia. 


2020 ◽  
Vol 3 (2) ◽  
pp. 16-19
Author(s):  
Prakash Ajmera ◽  
P Sailaja ◽  
P Raghu Ramulu

Background: Long-term damage and malfunction of various organ systems can be linked to diabetes and its related complications. The objective is to evaluate the microvascular and macrovascular complications of Type 2 Diabetes Mellitus. Subjects and Methods: Patients with confirmed diabetes attending OPD were included. A detailed history is recorded for each individual case with diabetes mellitus, obesity, symptoms and family history with individuals suffering from diabetes mellitus. The physical examination was done for sensory and motor signs. Prevalence rates were typically calculated and standardized for age and sex for microvascular and macrovascular complications at baseline. Results: The overall number of patients examined was 100, of which 54% were male and 46% were female. The mean age of the patients in the sample was 53 years. The prevalence of diabetes increased with age. The prevalence of diabetes in elderly patients was maximum for 61 to 70 years of age. 29 percent of patients have a positive history of diabetes in the family. 13% of patients were smokers and all of them were males. The risk factor – Hypertension –19%, Obesity – 25% and hypercholesterolemia – 43% were present at the time of diagnosis. Conclusion: The general risk of microvascular and macrovascular problems is severe in patients with type 2 diabetes that are relatively early in the disease phase. Such findings indicate that the early risk factor may be actively changed, especially in regions with a high prevalence of complications. There are important correlations between predominant diabetes and the rising circumference and body mass index. Coronary artery disease, nephropathy and retinopathy have become particularly prevalent.


2018 ◽  
Vol 7 (4) ◽  
pp. 243
Author(s):  
Najiah R. Nisa ◽  
Muharram Priatna ◽  
Yedy P. Sukmawan

Type 2 Diabetes mellitus (T2DM) is a degenerative disease and approximately 50% of patients with diabetes mellitus (DM) of more than 20 years’ duration also have diabetic nephropathy (DN). T2DM accounts for significant morbidity and mortality, however appropriate treatment can reduce the events. The objective of the study was to evaluate of drug use in inpatient T2DM and DN. This was a cross-sectional study with concurrent data retrieval on T2DM and DN inpatients in the period of March–June 2017 in one of hospitals in Taskimalaya, Indonesia. Forty-six patients were included in the study, of which 25 patients had T2DM and 21 had DN. The result of this study showed that appropriateness of drug selection reached 100% and 85.6% in T2DM and DN inpatients, respectively. Inappropriateness of drugs selection includes selection of ketorolac, ranitidine, folic acid, amlodipine and potassium containing drugs. Doses accuracy of T2DM patients reached 100% and of DN inpatients reached 92.1%. The inaccuracy of doses was due to the lack of dose adjustment to estimated glomerulus filtration rate (eGFR) level in each patient. Drugs interaction analysis showed a potential drug interaction on DN and T2DM which devided into major (13.8%; 7.2%), moderate (64.1%; 58%) and minor (22,1%; 34.8%). Based on the result, it is found an inappropriate drug selection and an inaccuracy of dose in DN patients, and a high percentage of drugs interaction on moderate classification in both diseases. It is necessary to optimize the role of pharmacist as a part of the healthcare team in the patient’s room to apply medication therapy management.Keywords: Drugs use evaluation, type 2 diabetes mellitus, diabetic nephropathyEvaluasi Penggunaan Obat pada Pasien Rawat Inap Diabetes Melitus Tipe 2 dan Nefropati Diabetik di Salah Satu Rumah Sakit di TasikmalayaAbstrakDiabetes melitus tipe 2 (DMT2) merupakan penyakit degeneratif dan sekitar 50% dari pasien yang telah menderita penyakit diabetes melitus (DM) selama lebih dari 20 tahun juga menderita penyakit nefropati diabetik (ND). Penyakit DMT2 dan nefropati diabetik mengakibatkan tingginya angka morbiditas dan mortalitas. Akan tetapi, penatalaksanaan terapi yang tepat dapat menurunkan kejadian tersebut. Tujuan penelitian ini adalah untuk melakukan evaluasi penggunaan obat pada pasien rawat inap dengan penyakit DMT2 dan ND. Penelitian ini menggunakan metode cross-sectional dengan pengambilan data secara konkuren terhadap pasien rawat inap DMT2 dan ND pada periode Maret–Juni tahun 2017 di salah satu rumah sakit di Tasikmalaya, Indonesia. Empat puluh enam pasien diikutsertakan, dengan 25 pasien menderita penyakit DMT2 dan 21 pasien menderita ND. Dari hasil penelitian ini, diperoleh ketepatan penggunaan obat pada penderita DMT2 mencapai 100% sedangkan pada penderita ND mencapai 85,6%. Ketidaktepatan pemilihan obat meliputi pemilihan ketorolac, ranitidine, asam folat, amlodipine dan kalium klorida. Ketepatan dosis pada penderita DMT2 mencapai 100%, sedangkan pada penderita ND mencapai 92,1%. Ketidaktepatan dosis disebabkan oleh tidak adanya penyesuaian dosis dengan nilai estimated glomerulus filtration rate (eGFR) terhadap pasien. Selain itu, ditemukan potensi interaksi obat pada penderita ND dan DMT2 yang diklasifikasikan ke dalam kategori mayor (13,8%; 7,2%), moderat (64,1%; 58%), dan minor (22,1%; 34,8%), secara berturut-turut. Berdasarkan hasil penelitian, ditemukan ketidaktepatan pemilihan obat dan ketidaktepatan dosis pada pasien ND serta tingginya persentase potensi interaksi obat, terutama kategori moderat, pada kedua penyakit. Diperlukan optimalisasi peran apoteker sebagai bagian dari tim di ruangan pasien rawat inap untuk melakukan penerapan pemantauan terapi obat.Kata kunci: Diabetes melitus tipe 2, evaluasi penggunaan obat, nefropati diabetik


2014 ◽  
Vol 21 (4) ◽  
pp. 313-318
Author(s):  
Mirela Tache ◽  
Sandra Milena Tocut ◽  
Carmen Dobjanschi

AbstractBackground and aims: Depression and cognitive disorders were reported more frequently in patients with diabetes mellitus (DM). Our aim was to analyze the association of cognitive disorders and depression association with chronic complications of DM in a group of Romanian patients. Materials and methods: The data was analyzed from 181 patients, with a mean age of 58,3 years to whom we applied the MMSE (Mini- Mental State Examination) and MADRS (Montgomery-Asberg Depression Rating Scale) questionnaires. We also analyzed the presence of chronic DM complications, HbA1c and lipid profile. Results: Most patients with type 2 diabetes mellitus (T2DM) had mild cognitive impairment (92%), more common in the age group 50-59 years. Chronic macrovascular complications were present in 74.58%, while chronic microvascular complications were present in 61.87% of patients with T2DM who associated mild and moderate cognitive impairment (p = 0.013). The most common form of depression was mild depression (90.2%), present in most patients with DM, regardless of progression and type of treatment. MADRS depression test scores were statistically significant correlated with the presence of peripheral artery disease - PAD (p <0.001), ischemic heart disease - IHD (p <0.001) and chronic kidney disease - CKD (p =0.05). We did not find a statistically significant correlation with HbA1c and serum lipid values (p˃0,05). Conclusion: Chronic diabetes macrovascular complications (PAD, IHD) and CKD were more frequently associated with cognitive disorders and depression in patients with T2DM independent of the degree of metabolic control.


2018 ◽  
Vol 7 (09) ◽  
pp. 1130-1135
Author(s):  
Rajendran Thilakavathi ◽  
Parthasarathy Prathiba ◽  
Pillanallur Rajendran Saiprashanth ◽  
Venkatachalam Vivek

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Nabila Maharani Suryanegara ◽  
Nuzirwan Acang ◽  
Yani Dewi Suryani

Diabetes melitus (DM) tipe 2 adalah gangguan metabolik karena tubuh mampu menghasilkan insulin, namun tidak dalam kadar normal atau tidak dapat berespons terhadap efek insulin (resistensi insulin) sehingga menyebabkan hiperglikemia. Jika kadar gula darah tidak dikontrol dengan baik maka akan dapat menyebabkan komplikasi kronis berupa mikrovaskular seperti penyakit mata, neuropati dan nefropati, serta makrovaskular seperti penyakit arteri koroner, arteri perifer, dan serebrovaskular. Pada tahun 2013, riset menunjukkan prevalensi penderita DM di Indonesia tinggi, terutama di Provinsi Sulawesi Tengah. Tujuan mengetahui komplikasi makrovaskular pada penderita diabetes melitus tipe 2 dengan kadar gula darah tidak terkontrol. Metode penelitian: Scoping review dengan mengidentifikasi, menganalisis, dan mengevaluasi suatu karya tulis ilmiah yang diterbitkan dalam rentang waktu 10 tahun terakhir yang dilakukan selama September—Desember 2020. Pencarian sistematis dilakukan melalui situs database yaitu Pubmed, Springer Link, dan Proquest. Sesuai dengan kriteria inklusi dan tidak termasuk eksklusi serta dilakukan skrining menggunakan kriteria kelayakan pada PRISMA dan disajikan dalam bentuk tabel hasil penelitian berisi uraian artikel penelitian yang telah di-review (9 artikel). Simpulan: Sembilan artikel menyatakan terdapat pengaruh kadar gula darah tidak terkontrol terhadap kemunculan komplikasi makrovaskular berupa penyakit arteri koroner, arteri perifer dan serebrovaskular pada pasien diabetes melitus tipe 2. Kadar gula darah tidak terkontrol berkaitan dengan pembentukan plak aterosklerosis serta gangguan fungsi endotel sehingga pasien dengan miokardiak infark, gangren, iskemik strok merupakan presentasi yang umum pada pasien dengan kadar gula darah tidak terkontrol. The Effect of Uncontrolled Blood Sugar Levels on Macrovascular Complications in Type 2 Diabetes Mellitus Patients: Scoping ReviewDiabetes mellitus (DM) type 2 is a metabolic disorder in which the body is able to produce insulin but not in normal levels or cannot respond to the effects of insulin (insulin resistance), causing hyperglycemia. If blood sugar levels are not properly controlled, it can lead to chronic complications in the form of microvascular diseases such as eye diseases, neuropathy and nephropathy and macrovascular diseases such as coronary artery disease, peripheral arteries and cerebrovascular. In 2013, research showed the high prevalence of DM sufferers in Indonesia, especially in the province of Central Sulawesi. Objective: To see the emergence of macrovascular complications in type 2 diabetes mellitus patietns with uncontrolled blood sugar levels. Research method: Scoping review by identifying, analyzing and evaluating a scientific paper published within the last 10 years, conducted in September—December 2020. Systematic searches were carried out through database sites, i.e Pubmed, Springer Link and Proquest. In accordance with inclusion and exclusion criteria, and screening was carried out using the PRISMA eligibility criteria and presented in the form of a research table containing a reviewed descriptions of research articles (9 articles). Conclusion: Nine articles stated that there was an effect of uncontrolled blood sugar levels on the emergence of macrovascular complications in the form of coronary artery disease, peripheral arteries and cerebrovascular disease in patients with type 2 diabetes mellitus. Uncontrolled blood sugar levels were associated with atherosclerotic plaque formation and impaired endothelial function. Myocardiac infarction, gangrene, ischemic stroke are common presentations in patients with uncontrolled blood sugar levels.


Sign in / Sign up

Export Citation Format

Share Document