scholarly journals FAKTOR – FAKTOR YANG BERHUBUNGAN DENGAN KEMAMPUAN MELAKUKAN DETEKSI HIPOGLIKEMIA PADA PASIEN DIABETES MELLITUS TIPE 2

2020 ◽  
Vol 3 (2) ◽  
pp. 9
Author(s):  
Cut Husna ◽  
Bahagia Akmal Saputra

Hypoglycemia is a condition characterized by measured blood sugar levels that are lower than normal values in type 2 diabetes mellitus (DM) patients. The impact of hypoglycemia cause a decrease in peripheral tissue perfusion resulting in decreased consciousness. Hypoglycemia detection is useful to early detect of the symptoms of hypoglycemi, hence it could be treated quickly and accurately. The purpose of this study is to determine the related factors (age, knowledge, long-term of diabetes mellitus, and the availability of blood glucose measuring devices) with the ability to detect hypoglycemia in patients with diabetes mellitus tipe 2 at a provincial hospital of Banda Aceh. This study used a descriptive correlative design. The study population was all diabetes mellitus type 2 patients who experienced hypoglycemia who visited to the Endocrine Polyclinic at a provincial hospital in Banda Aceh in 2018 totaling 1,364. The sampling used in this study is a purposive sampling technique for 99 respondents. Data collection using a questionnaire in a Gutman scale totaling 25 statements. The questionnaire reliability tested used Cronbach alpha = 0.955. Data were analyzed using the Chi-square test (α = 0.05). The results showed that no relationship between patient’s age with hypoglycemia detection ability (p=0.322), there was a relationship between knowledge with hypoglycemia detection ability (p=0.003), there was no relationship between long-term of diabetes mellitus with hipoglycemia detection ability (p=0.157), and there was a relationship between the availability of an independent glucose check (glucometer) with hypoglycemia detection ability (p=0.049). Based on the results, patient knowledge, availability of glukometer have a significantly affects on the ability to detect hypoglycemia. It is recommended to nurses in hospitals to increase knowledge of early detection of hypoglycemia in patients, education in using glucose check, and routine blood sugar checks in patients with diabetes mellitus.

Author(s):  
Larisa Dmitrievna Popovich ◽  
Svetlana Valentinovna Svetlichnaya ◽  
Aleksandr Alekseevich Moiseev

Diabetes – a disease in which the effect of the treatment substantially depends on the patient. Known a study showed that the use of glucometers with the technology of three-color display of test results facilitates self-monitoring of blood sugar and leads to a decrease in glycated hemoglobin (HbAlc). Purpose of the study: to modeling the impact of using of a glucometer with a color-coded display on the clinical outcomes of diabetes mellitus and calculating, the potential economic benefits of reducing the hospitalization rate of patients with diabetes. Material and methods. Based on data from two studies (O. Schnell et al. and M. Baxter et al.) simulation of the reduction in the number of complications with the use of a glucometer with a color indication. In a study by O. Schnell et al. a decrease of HbA1c by 0.69 percent is shown when using the considered type of glucometers, which was the basis of the model. Results. In the model, the use of a glucometer with a color-coded display for type 1 diabetes led to a decrease in the total number of complications by 9.2 thousand over 5 years per a cohort of 40 thousand patients with different initial levels of HbA1c. In a cohort of 40 thousand patients with type 2 diabetes, the simulated number of prevented complications was 1.7 thousand over 5 years. When extrapolating these data to all patients with diabetes included in the federal register of diabetes mellitus (FRD), the number of prevented complications was 55.4 thousand cases for type 1 diabetes and 67.1 thousand cases for type 2 diabetes. The possible economic effect from the use of the device by all patients with a diagnosis of diabetes, which are included in the FRD, estimated at 1.5 billion rubles for a cohort of patients with type 1 diabetes and 5.3 billion rubles for patients with type 2 diabetes. Conclusion. Improving the effectiveness of self-monitoring, which is the result of the use of glucometers with color indicators, can potentially significantly reduce the incidence of complications in diabetes and thereby provide significant economic benefits to society.


Author(s):  
Murray B Gordon ◽  
Kellie L Spiller

Summary Long-acting pasireotide is an effective treatment option for acromegaly, but it is associated with hyperglycemia, which could impact its use in patients with diabetes. We present a case of a 53-year-old man with acromegaly and type 2 diabetes mellitus (glycated hemoglobin (HbA1c): 7.5%), who refused surgery to remove a pituitary macroadenoma and enrolled in a Phase 3 clinical trial comparing long-acting pasireotide and long-acting octreotide in acromegalic patients. The patient initially received octreotide, but insulin-like growth factor 1 (IGF-1) levels remained elevated after 12 months (383.9 ng/mL; 193.0 ng/mL; reference range: 86.5–223.8 ng/mL), indicating uncontrolled acromegaly. He switched to pasireotide 40 mg and subsequently increased to 60 mg. Within 6 months, IGF-1 levels normalized (193.0 ng/mL), and they were mostly normal for the next 62 months of treatment with pasireotide (median IGF-1: 190.7 ng/mL). Additionally, HbA1c levels remained similar to or lower than baseline levels (range, 6.7% to 7.8%) during treatment with pasireotide despite major changes to the patient’s antidiabetic regimen, which included insulin and metformin. Uncontrolled acromegaly can result in hyperglycemia due to an increase in insulin resistance. Despite having insulin-requiring type 2 diabetes, the patient presented here did not experience a long-term increase in HbA1c levels upon initiating pasireotide, likely because long-term control of acromegaly resulted in increased insulin sensitivity. This case highlights the utility of long-acting pasireotide to treat acromegaly in patients whose levels were uncontrolled after long-acting octreotide and who manage diabetes with insulin. Learning points Long-acting pasireotide provided adequate, long-term biochemical control of acromegaly in a patient with insulin-requiring type 2 diabetes mellitus who was unresponsive to long-acting octreotide. Glycemic levels initially increased after starting treatment with pasireotide but quickly stabilized as acromegaly became controlled. Long-acting pasireotide, along with an appropriate antidiabetic regimen, may be a suitable therapy for patients with acromegaly who also have insulin-requiring type 2 diabetes mellitus.


2016 ◽  
Vol 7 (2) ◽  
Author(s):  
Paul C Langley ◽  
Taeho Greg Rhee

Over the past 20 years a number of simulations or models have been developed as a basis for tracking and evaluating the impact of pharmacological and other interventions in type 1 and type 2 diabetes mellitus. These models have typically tracked the natural course of these diseases generating long-term composite claims for cost-effectiveness. These claims can extend over the lifetime of the modeled patient cohort. Set against the standards of normal science, however, these claims lack credibility. The claims presented are all too often either immune to failure or are presented in a form that is non-testable. As such they fail to meet the key experimental requirements of falsification and replication. Unfortunately, there is a continuing belief that long-term or lifetime models are essential to decision-making. This is misplaced. The purpose of this review is to argue that there is a pressing need to reconsider the needs of health system decision makers and focus on modeled or simulated claims that are meaningful, testable, reportable and replicable in evaluating interventions in diabetes mellitus.   Type: Commentary


2020 ◽  
Vol 8 (1) ◽  
pp. e001135 ◽  
Author(s):  
Sazan Rasul ◽  
Barbara Katharina Geist ◽  
Helmut Brath ◽  
Pascal Baltzer ◽  
Lalith Kumar Shiyam Sundar ◽  
...  

IntroductionInhibitors of sodium-glucose linked transporter-2 (SGLT2i) are enhancing glucose excretion in the proximal renal tubules, and thus are increasingly used to lower blood glucose levels in patients with type 2 diabetes mellitus (T2DM). The glucose analog 2-deoxy-2-(18F) fluoro-D-glucose (FDG) can be used to quantify renal function in vivo, and due to an affinity for SGLT2 could also provide information about SGLT2 transporter function. Our objectives in this study were, therefore, to assess the impact of SGLT2i on renal function parameters in patients with T2DM and identify predictive parameters of long-term response to SGLT2i using dynamic FDG positron emission tomography (PET)/MRI.MethodsPET FDG renal function measures such as mean transit time (MTT) and general renal performance (GRP) together with glomerular filtration rate (GFR) were determined in 20 patients with T2DM before (T2DMbaseline) and 2 weeks after initiation of therapy with SGLT2i (T2DMSGLT2i). Additionally, dynamic FDG PET data of 24 healthy subjects were used as controls.ResultsMTT in T2DMbaseline was significantly higher than in healthy controls (5.7 min vs 4.3 min, p=0.012) and significantly decreased to 4.4 min in T2DMSGLT2i (p=0.004). GRP of T2DMSGLT2i was higher than of T2DMbaseline (5.2 vs 4.7, p=0.02) and higher but not significantly than of healthy individuals (5.2 vs 5.1, p=0.34). Expectedly, GFR of healthy participants was significantly higher than of T2DMbaseline and T2DMSGLT2i (122 vs 92 and 86 mL/min/1.73 m², respectively; p<0.001). The higher the GRP value in kidneys of T2DMSGLT2i, the lower was the glycated hemoglobin level 3 months after therapy initiation.ConclusionMTT and GRP values of patients with T2DM shifted significantly toward values of healthy control 2 weeks after therapy with SGLT2i begins. GRP in T2DMSGLT2i was associated with better long-term glycemic response 3 months after initiation of therapy.Trial registration numberNCT03557138.


2015 ◽  
Vol 2 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Hatim Kouismi ◽  
Sanae Hammi ◽  
Khalid Bouti ◽  
Aziza Rhanim ◽  
Khaoula El Ataouna ◽  
...  

Background : About 95% of patients with tuberculosis (TB) and 70% of patients with diabetes mellitus (DM) live in low and middle-income countries. As a result, DM and TB are increasingly occurring together. The risk of tuberculosis is two to five times greater in patients with diabetes.The purpose of this study is to analyze the characteristics of pulmonary tuberculosis in patients with diabetes and to evaluate the impact of tuberculosis on diabetes control. Patients and Methods : This is a retrospective study of 80 patients with confirmed pulmonary tuberculosis, comparing 30 patients with diabetes with 50 without diabetes. Results : Diabetes was more frequent in older patients with tuberculosis and in male patients. 63,3% had type 2 diabetes. Tuberculosis symptoms did not differ between the two groups. Involvement of basal segments of the lower lobes and cavitation occurred more frequently in patients with diabetes, but this difference was not significant. The time for conversion to negative of sputum culture was longer in control patients (44,1 ± 20,2 days) than in case (36 ± 18.3) (p = 0.08). Conclusion : Tuberculosis is frequently associated with diabetes mainly in low-income countries. The problem with this association could be accentuated in the future


2021 ◽  
Vol 1 (2) ◽  
pp. 112-117
Author(s):  
Fahruddin Kurdi ◽  
Zainal Abidin ◽  
Ratna Puji Priyanti ◽  
Anja Hesnia Kholis

Elderly are high risk for the development of type 2 diabetes due to the combined effects of increasing insulin resistance and impaired pancreatic function with aging. Diabetes mellitus is a chronic disease that causes insulin in the pancreas is not effective one of the treatments that can be done by diabetics to reduce blood sugar levels One of them with physical activity, the activity is taichi exercises.The purpose of this study was to investigate the effect of taichi exercises on reducing blood sugar levels in patients with type II diabetes mellitus.The design of this study was pre-experiment one group pre-test and post-test design with a population of 88 patients and a sample of 44 respondents. Research sampling technique used purposive sampling. Data collection with observation sheets. The intervention was carried out four times during 4 weeks. Before the intervention, sugar levels of type II diabetics were classified as moderate as 24 people (54.5%) and high as many as 20 people (45.5%). After the management of taichi exercises sugar levels experienced changes in the categories of good as many as 16 people (36.4%), moderate as many as 20 people (45.5%) and high as many as 8 people (18.2%). Data analized with Wilcoxon Signed Rank test with a significant level α = 0.05, the result ρ-value = 0.001 means ρ-value <α so that there is a significant effect of taichi exercises on decreasing blood sugar levels in patients with type II diabetes mellitus. Blood sugar levels in patients with diabetes mellitus before doing taichi exercises with the number of respondents 44 people mostly experienced changes, evidenced by the level of blood sugar levels from moderate levels to good. Keywords: Elderly, Taichi, Diabetes Mellitus, Blood sugar level


2021 ◽  
Vol 1 ◽  
pp. 1088-1096
Author(s):  
Regina Merdekari Rizki Ananda ◽  
Dafid Arifiyanto

AbstractDiabetes Mellitus is a group of metaboloc disoreders with sysptoms of increased blood sugar levels(hyperglycaemia) which results in damages to insulin secretion, insulin secretion,insulin activity, or both wrong behaviour ina diabetic diet will make blood sugar levels unstable and will have an impact in patients health problems. This study aimed to describe compliance in patients with type 2 diabetes mellitus through a literature review. The method used in the literature review wa to search for articles from 2011-2021 through NCBI searchles and the Garuda Portal. The searching results were obtained in the from of full text and pdf,rhen reviewed by using the strobe instrument,extracted then discussed, and concluded. The results of a literature review of 5 articles showed that there was an effect of dietary compliancr in patients with diabetes mellitus with results. Dietary adherence of diabetes patients was 324 respondents (58%) non-adherence and 235 respondents (42%) obedient in dientary compliance in type 2 diabetes mellitus patients. It can be concluded thet non-adherence diabetic patients can experience unstable blood sugar levels. Nurses should be able to increase the understanding of the importance of dietary compliance for patients with diabetes mellitus.Keywords: Compliance, Diet, Diabetes Mellitus. AbstrakDiabetes melitus merupakan sekumpulan hambatan metabolik dengan gejala peningkatan kadar gula darah (hiperglikemia) yang berdampak kerusakan sekresi insulin,aktivitas insulin, atau keduanya. Perilaku yang salah dalam diet diabetes akan menjadikan kadar gula darah tidak stabil dan akan berdampak pada gangguan kesehatan pada pasien. Penelitian ini bertujuan untuk mengetahui pengaruh kepatuhan diet pada penderita diabetes melitus tipe 2 melalui literatur review. Metode yang digunakan dalam literature review adalah mencari artikel tahun 2011-2021 melalui penelusuran Ncbi dan Portal Garuda. Hasil pencarian yang didapatkan berupa fulltext dan pdf, kemudian direview dengan menggunakan Intrumen strobe, diekstraksi kemudian dibahas dan disimpulkan. Hasil penelitian literature review dari 5 artikel menunjukkan bahwa adanya pengaruh terhadap kepatuhan diet pada pasien diabetes mellitus dengan hasil Kepatuhan diet pasien diabetes 324 responden (58%) tidak patuh dan 235 responden (42%) patuh dalam Kepatuhan Diet Pada Penderita Diabetes Mellitus Tipe 2. Pada penelitian ini didapatkan hasil penderita diabetes tidak patuh menjalani diet sehingga kadar gula darah dalam tubuh tidak stabil. Bagi perawat hendaknya dapat meningkatkan pemahaman tentang kepatuhan guna dapat memperbaiki diet bagi pasien Diabetes mellitus.Kata kunci: Kepatuhan , Diet, dan Diabetes Mellitus.


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