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"Diketahui kekerapan diabetes melitus (DM) sangat tinggi pada sirosis hepatitis (SH) post netkrotik (makronodular) yang diidap 90% pasien di Indonesia. Meskipun demikian patofisiologisnya tetap belum jelas dan sampai saat ini kelompok pasien SH DM belum dicantumkan dalam klasifikasi baru diabetes melitus 1980. Oleh karena itu penelitian ini akan menilai kemampuan fungsional dan cadangan sel beta pankreas serta memberikan nama dan pendekatan klinis pada diabetes melitus tipe sirosis hepatis untuk kelompok pasien yang disebut sirosis hepatis untuk kelompok pasien yang disebut sirosis hepatis dengan diabetes melitus agar sesuai dengan klasifikasi diabetes melitus baru 1980. pada akhirnya akan disusun patofisiologi DM tipe SH"

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

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

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

"LATAR BELAKANG. Progresifitas penurunan sekresi insulin sudah terjadi sebelum individu didiagnosis sebaai DM tipe-2 baru karena kelelahan sel beta pankreas untuk mengatasi resistensi insulin. Efek glukotoksisitas, Iipotoksisitas dan amiloidosis pada sel beta pankreas menyebabkan proses tersebut terus berlanjut walaupun pasien telah diterapi dengan baik. Berbagai penelitian memperlihatkan sebagian besar penyandang DM tipe-2 baru ditemukan dengan fungsi sel beta pankreas yang sudah rendah. Populasi tersebut lebih cepat mengalami kegagalan terapi dibandingkan populasi dengan fungsi sel beta pankreas yang masih baik akibat progresifitas penurunan sekresi insulin yang lebih cepat, sedangkan resistensi insulin dalam tingkatan yang sama. Akibatnya prevalensi kegagalan mencapai kontrol glukosa darah yang baik menjadi tinggi pada populasi tersebut, dan merupakan salah satu penyebab komplikasi makrovaskular maupun mikrovaskular yang semakin meningkat. Di poliklinik diabetes RSCM dan berbagai puskesrnas di Jakarta, sebagian besar penyandang DM tipe-2 sulit untuk mencapai kontrol glukosa darah yang baik dan tingginya prevalensi komplikasi makrovaskular maupun mikrovaskular. Apakah populasi tersebut sudah berada dalam fungsi sel beta pankreas yang rendah? Penelitian ¡ni bertujuan untuk mengetahui gambaran fungsi sel beta pankreas melaluiperhitungan HOMA-B dan resistensi insulin melalui perhitungan HOMA-IR padasubyek penyandang DM tipe-2 baru yang berobat di poliklinik diabetes RSCM.METODOLOGI. Dirancang studi potong lintang dengan analisis deskriptif. Prosedur yang dilakukan adalah subyek dipuasakan selama 10 jam lalu diperiksa konsentrasi glukosa darah puasa dan insulin puasa. Dari hasil tersebut dilakukan penghitungan HOMA-B dan HOMA-IR.HASIL. Telah dilakukan pengambilan data terhadap 100 subyek. Nilai median usia 52 tahun. 51% dan subyek mempunyai riwayat keluarga DM dan sebagian besar subyek adalah obes sebanyak 54%. Sebagian besar subyek dalam kelompok nilai HOMA-B yang sangat rendah yaitu kurang dari 25 pmol/mmol sebanyak 55% dengan nilai median 17,14 pmol/mmol, dan dalam kelompok nilai HOMA-IR yang rendah yaitu kurang dari 3 pmol-mmol/l2 scbanyak 61% dengan niai median 245 pmol-mmol/l2.SIMPULAN. Sebagian besar penyandang DM tipe-2 baru di poliklinik diabetes RSCM adalah obes dan manpunyai riwayat keluarga DM. Sebagian besar subyek berada dalam kelompok fungsi sel beta pankreas dan resistensi insulin yang rendah.

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BACKGROUND. The declining of insulin secretion already happened before the patent diagnosed type 2 diabetic, caused by beta cell pancreas failure in order to compensate insulin resistance. The glucotoxicity and lipotoxicity effect combined with amyloidosis onì beta cell pancreas caused continuing declining process progessiveIy even though the patient has been treated. Most of the previous studies showed that many new type 2 diabetic patients have already had low beta cell finction. This population failed to achieve targeted therapy faster than population with good beta cell function, because faster the declining of insulin secretion. However, innsulin resistance was almost constant. Because of that, prevalence of failed to achieve good blood glucose control were high and one of the mechanisms cause micro and macro vascular complication will increase. Many type 2 diabetic who attended in endocrine metabolic clinic in Cipto Mangunkusumo hospital and Primary Health Care in Jakarta failed to achieve good blood glucose control and there were high incidence of macro and micro vascular complication We hypothesized that many new type 2 diabetIc patients in endocrine metabolic clinic in Cipto Mangunkusumo have already had low beta cells function. We investigated the profile of beta cells function by calculated IIOMA-13 and insulin resistance by calculated ROMA-IR in new type 2 diabetic patients who attenckxl in endocrine metabolic clinic ¡n Cipto Mangunkusumo hospital.METHOD. A descriptive-cross sectional study was conducted. After 10 hours fasting, new type 2 diabetic patients were checked for fasting blood glucose and fasting insulin concentration. Based on those numbei, The HOMA-B and HOMA-IR were calculated.RESULT. Based on the results of 100 patients. Median value of age was 52 years old. 51% of the subjects had family history of diabetic and most of them were obese in 54% subjects. Most of the subjects were in lower HOMA-B value less than 25 Pmol/mmol in 55% of the subiects with median NOMA-B vahe was 17,14 pmol/mmol and wese in lower HOMA-IR less than 3 pmol-mmol,I2 in 61% of the subjects with median HOMA-ER value was 2,45 pmol-mmol/12 groups.CONCLUSION. Many new type 2 diabetic patients, who attended in endocrine metabolic Clinic in Cipto Mangunkusumo hospital, were obese and have already had family history of diabetic. Most of the subjects were in low pancreas beta cell function and insulin resistance groups."

"Latar BelakangDiabetes mellitus merupakan penyakit gangguan metabolik dengan jumlah penderita yang tergolong tinggi baik di dunia maupun di Indonesia. Salah satu faktor risiko dari diabetes mellitus adalah obesitas. Obesitas dapat menyebabkan akumulasi lemak yang memicu kondisi diabetes melalui disfungsi sel beta dan resistensi insulin. Indeks yang dapat digunakan untuk mengukur akumulasi lemak adalah indeks lipid accumulation product (LAP). Sejauh ini, indeks LAP ditemukan berkaitan dengan kejadian diabetes mellitus tipe 2 pada berbagai populasi. Meskipun demikian, penelitian yang menelusuri hubungan antara indeks LAP dengan disfungsi sel beta dan resistensi insulin sebagai penyebab diabetes mellitus tipe 2 masih terbatas.MetodeStudi observasional dengan desain potong lintang ini menggunakan data sekunder dengan merekrut populasi orang dewasa nondiabetes pada tahun 2018 dan 2019. Pada subjek tersebut, pemeriksaan antropometri dan pengambilan darah dilakukan untuk memperoleh kadar glukosa darah puasa, insulin puasa, dan trigliserida. Analisis dilakukan dengan menggunakan uji korelasi dan regresi linier untuk melihat hubungan antara indeks LAP dengan fungsi sel beta pankreas dan resistensi insulin setelah disesuaikan oleh variabel perancu.HasilPenelitian ini melibatkan 81 subjek dewasa nondiabetes dengan usia 51,54 ± 7,29 tahun. Ditemukan korelasi positif yang signifikan (p<0,01) antara lipid accumulation product (LAP) dengan fungsi sel beta pankreas (r = 0,39) dan resistensi insulin (r = 0,44). Setelah dilakukan penyesuaian variabel perancu pada analisis multivariat, indeks LAP tidak menunjukkan hubungan yang signifikan terhadap fungsi sel beta pankreas dan resistensi insulin.KesimpulanPenelitian ini menunjukkan adanya hubungan yang signifikan antara indeks LAP dan fungsi sel beta pankreas dan resistensi insulin pada populasi dewasa nondiabetes. Dibutuhkan studi lebih lanjut untuk menentukan kausalitas pada asosiasi tersebut.

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Introduction

Diabetes mellitus is a metabolic disorder with high prevalence worldwide, including Indonesia. One of the risk factors for diabetes mellitus is obesity, which can lead to fat accumulation causing diabetes through beta cell dysfunction and insulin resistance. Lipid accumulation product (LAP) is an index used to measure fat accumulation. LAP has been found to be associated with the occurrence of type 2 diabetes mellitus in various populations. However, studies investigating between LAP index and beta cell dysfunction and insulin resistance as causes of type 2 diabetes mellitus are still limited.

Method

This cross-sectional observational study used secondary data to recruit nondiabetic adults in 2018 and 2019. Anthropometric measurements and blood samples were taken. Statistical analysis was conducted using correlation test and linear regression to examine the relationship between LAP index and pancreatic beta cell function and insulin resistance after adjusting for confounding variables.

Results

This study involved 81 nondiabetic adult subjects with an average age of 51.54 ± 7.29 years old. Significant positive correlation (p<0.01) was found between LAP index and beta cell function (r = 0.39) dan resistensi insulin (r = 0.44). After adjusting for confounding variables in multivariate analysis, the LAP index did not show a significant relationship with beta cell function and insulin resistance.

Conclusion

This study demonstrated a significant association of LAP index with beta cell function and insulin resistance in nondiabetic adult population. Further research is needed to determine causality."

"Indonesian Journal of Dentistry; Edisi Khusus KPPIKG XIV: 333-337Hyperglycemia which occurs in type 2 diabetic patient increases prostaglandin E2 (PGE2), cytokine expression, and decreases neutrophil phagocytotic function. This will induce inflammation and periodontal destruction, thus decreasing periodontal status. The aim of the study was to analyze the pattern of interleukine-1β (IL-1β) level, phagocytotic function, and periodontal status. The study's design was cross-sectional on 45 controlled diabetes mellitus (CDM) and 45 uncontrolled diabetes mellitus (UCDM) subjects and 45 non diabetic subjects, 40-60 years old in Metabolic-Endocrinology Clinic Cipto Mangunkusumo Hospital. Statistical analysis was performed using a Stata 7.0 software computer. The result showed that the pattern alteration of increasing IL-1β level was in 2 hours-post prandial glucose level of >150mg/dL, decreasing phagocytotic function in glucose level of >170mg/dL, and decreasing periodontal status in glucose level of >240mg/dL. Therefore it is concluded that the pattern alteration of decreasing periodontal status, increasing IL-1β, and decreasing phagocytotic function showed on certain blood glucose level."

"Maen pukulan merupakan budaya Betawi yang mengandung unsur olah raga, budaya, spiritual, dan bela diri. Ia merupakan warisan yang hidup pada masyarakat Betawi serta Jakarta dan sekitarnya. Satu aliran maen pukulan yang relatif lama, eksis, dan populer pada masa kini ialah Beksi Tradisional H. Hasbullah. Tujuan penelitian ini ialah mengkaji penggunaan memori kolektif pada perguruan maen pukulan Beksi Tradisional H. Hasbullah sebagai bagian dari budaya masyarakat Betawi dilihat dari sistem pewarisan dan pengelolaan perguruan pada masa kini. Pada perguruan tersebut, memori yang terpelihara terbagi menjadi memori individu yang teraplikasi pada guru maen pukul dan memori kolektif yang terdapat pada komunitas. Menggunakan tiga teori mengenai memori kolektif oleh Rubin, Bernecker, dan Halbwachs ditemukan bahwa maen pukulan Beksi Tradisional H. Hasbullah berkembang menggunakan memori kolektif para guru, murid, serta masyarakat yang menanggap pertunjukan Beksi. Ditemukan pula memori individu guru membentuk pola pewarisan yang ia pilih bagi muridnya serta tipe pengelolaan yang digunakan dalam kepengurusan perguruan. Memori kolektif berperan pada pertunjukan yang mengandung Beksi di dalamnya. Memori menjadi panduan ketika terjadi perbedaan walau di sisi lain, memori yang tereduksi menyebabkan terjadinya pengerucutan pakem pertunjukan. Penelitian ini menunjukkan pentingnya peran memori kolektif untuk eksistensi dan perkembangan maen pukulan di masa depan.

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Maen pukulan is a part of Betawinese tradition that contains sport, cultural, spiritual, and martial arts elements. It is a living heritage among Betawinese community and is found in Jakarta and its surrounding areas. A relatively old school of maen pukulan which still exists and popular today is the H. Hasbullah’s Traditional Beksi. This research aims to investigate the use of collective memory in the current Maen Pukulan Beksi Traditional H.Hasbullah schools as a part of Betawinese culture related to its cultural inheritance pattern and management. At the maen pukulan schools, there are two types of preserved memory. The first is individual memory which is applied by the maen pukulan gurus and the second is collective memory which is found among the community. Using three theories about collective memory by Rubin, Bernecker, and Halbwachs, it is found that the traditional maen pukulan Beksi of H. Hasbullah has developed through the collective memory of the gurus, students, and the publics who perceive the Beksi performance. It is also found that individual memory of the gurus forms an inheritance pattern which they choose for their students and the type of management use at the maen pukulan school organisation. Collective memory has its role in the performance that contains Beksi in it. The memory, on the one hand, becomes their guide when there is a dispute about Beksi. On the other hand, reduced memory has caused some changes and reduction, along with the continuity in the maen pukulan Beksi performance. This research shows the important role of collective memory in maintaining the existence and development of maen pukulan in the future."

"[ABSTRAKLatar belakang : Hiperglikemia kronik pada pasien Diabetes melitus tipe 1 (DMT1) dihubungkan dengan kerusakan jangka panjang, gangguan fungsi dan kerusakan berbagai organ tubuh lain seperti mata, ginjal, saraf, jantung dan pembuluh kapiler. Salah satu gangguan fungsi organ yang sering diabaikan sebagai akibat hiperglikemia adalah faal paru. Uji fungsi paru dapat membedakan kelainan paru obstruktif, restriktif atau campuran antara obstruktif dn restriktif. Uji fungsi paru dengan spirometri tidak dapat dilakukan dengan baik pada anak dibawah usia 7 atau 8 tahun karena memerlukan koordinasi yang cukup sulit. Penelitian tentang dampak DMT1 terhadap paru di Indonesia belum ada sampai saat ini.Tujuan : Mengetahui gambaran uji fungsi paru pada pasien DMT1 usia 8-18 tahun.Metode : Penelitian potong lintang dilakukan di Poliklinik Endokrinologi dan Respirologi Rumah Sakit Cipto Mangunkusumo (RSCM), serta Laboratorium Prodia Salemba pada bulan Januari 2015. Wawancara orangtua dilakukan dan data kadar HbA1c dalam rentang satu tahun terakhir diambil dari rekam medis subjek atau berdasarkan hasil pemeriksaan sebelumnya. Uji fungsi paru dilakukan sebanyak tiga kali dan diambil salah satu hasil yang terbaik. Kemudian subjek menjalani pengambilan darah untuk pemeriksaan kadar HbA1c dengan metode cation-exchange high pressure liquod chromatography (HPLC) di Laboratorium Prodia.Hasil : Tiga puluh lima subjek berpartisipasi dalam penelitian, terdiri dari 68,6% perempuan. Rerata usia 14 ± 2,7 tahun dan median durasi DM adalah 4 tahun (1,3-10,2 tahun). Rerata parameter FEV1 adalah 86,8 ± 14%, FVC 82,7 ± 12% dan V25 83,1 ± 26,2%. Median FEV1/FVC adalah 92,4 % (77,6-100) dan V50 91,5 % (41,1-204). Fungsi paru normal didapatkan pada 19 subjek (54,3%) dan fungsi paru terganggu sebanyak 16 subjek (45,7%), terdiri dari 10 subjek (28,6%) gangguan restriktif, 2 subjek (5,7%) gangguan obstruktif dan 4 subjek (11,4%) gangguan campuran. Rerata HbA1c dalam 1 tahun terakhir pada subjek dengan gangguan restriktif adalah 10,3%. Simpulan : Nilai parameter uji fungsi paru pasien DMT1 usia 8-18 tahun masih dalam batas normal. Gangguan fungsi paru didapatkan pada 16 subjek (45,7%) dengan gangguan restriksi terbanyak yaitu 10 subjek (28,6%).

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ABSTRACTBackground: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia.Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old.Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory.Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%.Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder.;Background: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia. Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old. Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory. Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%. Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder., Background: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia. Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old. Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory. Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%. Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder.]"

"[ABSTRAK Latar Belakang Diabetes melitus DM tipe 1 paling banyak ditemukan pada masa anak dan remaja dengan prevalens sebesar 1 500 anak Hiperglikemia kronik pada diabetes menyebabkan komplikasi pada berbagai organ Komplikasi ini berhubungan dengan kadar HbA1C sebagai faktor yang memengaruhi fungsi kognitif Pasien DM tipe 1 juga dapat mengalami komplikasi hipoglikemia berat sehingga mengakibatkan atrofi neuron di otak Identifikasi dini terhadap risiko gangguan fungsi kognitif penting untuk intervensi klinis dan psikoedukasi terhadap anak Tujuan Mengidentifikasi prevalens anak DM dengan fungsi kognitif di bawah normal di Indonesia dan menganalisis korelasi antara usia awitan DM durasi sakit DM ketoasidosis diabetikum KAD HbA1C dan hipoglikemia berat dengan fungsi kognitif anak DM tipe 1 Metode Penelitian ini merupakan studi yang mempelajari faktor risiko dengan metode potong lintang dilakukan di Jakarta pada Mei sampai dengan Juni 2015 Pemeriksaan fungsi kognitif menggunakan instrumen the Wechsler Intelligence Scale for Children WISC IV Subyek pada penelitian ini adalah pasien DM tipe 1 yang berusia 5 ndash 18 tahun Analisis statistik dilakukan untuk mencari korelasi antara fungsi kognitif dengan usia awitan durasi sakit kadar HbA1C dan frekuensi kejadian KAD Analisis statistik komparasi dilakukan untuk mencari rerata perbedaan full scale intelligence quotient IQ pasien dengan riwayat hipoglikemia berat dan tidak Hasil Penelitian dilakukan terhadap 58 subyek dengan hasil rerata full scale IQ adalah 100 16 Terdapat 26 subyek dengan full scale IQ di bawah normal Korelasi bermakna secara statistik didapatkan antara fungsi kognitif dengan usia awitan r 0 285 p 0 030 kadar HbA1C r 0 270 p 0 041 dan frekuensi riwayat kejadian KAD r 0 289 p 0 028 Tidak didapatkan korelasi antara durasi sakit dengan full scale IQ dan tidak didapatkan perbedaan full scale IQ antara kelompok dengan riwayat hipoglikemia berat dan kontrol Simpulan Terdapat korelasi negatif antara full scale IQ dengan usia awitan frekuensi KAD dan kadar HbA1C Durasi sakit dan riwayat hipoglikemia berat tidak memengaruhi full scale IQ Kata kunci faktor fungsi kognitif DM tipe 1 ABSTRACT Background Type 1 diabetes is mostly found in childhood and adolescence with prevalence of 1 500 children Chronic hyperglycemia causes complications in organs especially the eyes kidneys nerves blood vessels and heart These complications are associated with HbA1C levels as one of the factors affecting cognitive ability Patients with type 1 diabetes may also experience complications caused by severe hypoglycemia resulting in atrophy of neurons in the brain Early identification to the risk of complication in cognitive ability is important for clinical interventions and psychoeducation Aim To identify the prevalence of diabetic children with under average cognitive ability in Indonesia and to determine the correlation between the age of onset of diabetes duration of illness diabetic ketoacidosis DKA HbA1C severe hypoglycemia and cognitive ability of children with type 1 diabetes mellitus Method This is a cross sectional and risk factors study held in Jakarta from May to June 2015 Assessment of cognitive ability was done with the Wechsler Intelligence Scale for Children WISC IV Subjects in this study were type 1 diabetic patients aged 5 18 years Statistical analysis was performed to find the correlation among cognitive ability and age of onset duration of illness HbA1C levels and frequency of DKA Comparative statistical analysis was performed to find the mean difference in full scale IQ intelligence quotient of patients who had or did not have a history of severe hypoglycemia Result This study had 58 subjects with a mean full scale IQ 100 16 Nineteen percent subjects had full scale IQ under average We found statistically significant correlations between cognitive ability and the age of onset r 0 285 p 0 030 HbA1C levels r 0 270 p 0 041 and the frequency of occurrence DKA history r 0 289 p 0 028 There was no correlation between the duration of illness and full scale IQ There was no full scale IQ difference between groups with a history of severe hypoglycemia and control Conclusion There were negative correlations between full scale IQ and age of onset frequency DKA and HbA1C levels The duration of illness and history of severe hypoglycemia did not affect the full scale IQ Keywords factors cognitive function type 1 diabetes;Background Type 1 diabetes is mostly found in childhood and adolescence with prevalence of 1 500 children Chronic hyperglycemia causes complications in organs especially the eyes kidneys nerves blood vessels and heart These complications are associated with HbA1C levels as one of the factors affecting cognitive ability Patients with type 1 diabetes may also experience complications caused by severe hypoglycemia resulting in atrophy of neurons in the brain Early identification to the risk of complication in cognitive ability is important for clinical interventions and psychoeducation Aim To identify the prevalence of diabetic children with under average cognitive ability in Indonesia and to determine the correlation between the age of onset of diabetes duration of illness diabetic ketoacidosis DKA HbA1C severe hypoglycemia and cognitive ability of children with type 1 diabetes mellitus Method This is a cross sectional and risk factors study held in Jakarta from May to June 2015 Assessment of cognitive ability was done with the Wechsler Intelligence Scale for Children WISC IV Subjects in this study were type 1 diabetic patients aged 5 18 years Statistical analysis was performed to find the correlation among cognitive ability and age of onset duration of illness HbA1C levels and frequency of DKA Comparative statistical analysis was performed to find the mean difference in full scale IQ intelligence quotient of patients who had or did not have a history of severe hypoglycemia Result This study had 58 subjects with a mean full scale IQ 100 16 Nineteen percent subjects had full scale IQ under average We found statistically significant correlations between cognitive ability and the age of onset r 0 285 p 0 030 HbA1C levels r 0 270 p 0 041 and the frequency of occurrence DKA history r 0 289 p 0 028 There was no correlation between the duration of illness and full scale IQ There was no full scale IQ difference between groups with a history of severe hypoglycemia and control Conclusion There were negative correlations between full scale IQ and age of onset frequency DKA and HbA1C levels The duration of illness and history of severe hypoglycemia did not affect the full scale IQ Keywords factors cognitive function type 1 diabetes, Background Type 1 diabetes is mostly found in childhood and adolescence with prevalence of 1 500 children Chronic hyperglycemia causes complications in organs especially the eyes kidneys nerves blood vessels and heart These complications are associated with HbA1C levels as one of the factors affecting cognitive ability Patients with type 1 diabetes may also experience complications caused by severe hypoglycemia resulting in atrophy of neurons in the brain Early identification to the risk of complication in cognitive ability is important for clinical interventions and psychoeducation Aim To identify the prevalence of diabetic children with under average cognitive ability in Indonesia and to determine the correlation between the age of onset of diabetes duration of illness diabetic ketoacidosis DKA HbA1C severe hypoglycemia and cognitive ability of children with type 1 diabetes mellitus Method This is a cross sectional and risk factors study held in Jakarta from May to June 2015 Assessment of cognitive ability was done with the Wechsler Intelligence Scale for Children WISC IV Subjects in this study were type 1 diabetic patients aged 5 18 years Statistical analysis was performed to find the correlation among cognitive ability and age of onset duration of illness HbA1C levels and frequency of DKA Comparative statistical analysis was performed to find the mean difference in full scale IQ intelligence quotient of patients who had or did not have a history of severe hypoglycemia Result This study had 58 subjects with a mean full scale IQ 100 16 Nineteen percent subjects had full scale IQ under average We found statistically significant correlations between cognitive ability and the age of onset r 0 285 p 0 030 HbA1C levels r 0 270 p 0 041 and the frequency of occurrence DKA history r 0 289 p 0 028 There was no correlation between the duration of illness and full scale IQ There was no full scale IQ difference between groups with a history of severe hypoglycemia and control Conclusion There were negative correlations between full scale IQ and age of onset frequency DKA and HbA1C levels The duration of illness and history of severe hypoglycemia did not affect the full scale IQ Keywords factors cognitive function type 1 diabetes]"