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Teti Sri Gunarti
"Latar Belakang: Diabetes melitus (DM) Tipe 1 merupakan penyakit kronis yang berlangsung seumur hidup dan membutuhkan pendekatan multidisiplin dari profesional kesehatan yang terkait di bidangnya. Edukator diabetes merupakan tenaga kesehatan yang bertugas membantu penderita diabetes mengubah perilaku hidup penderita untuk mencapai status kesehatan yang optimal dengan memberikan edukasi kepada pasien dan keluarga. Saat ini edukator DM tipe 1 pada anak di Indonesia belum terbentuk. Diperlukan model pelatihan yang efektif untuk membentuk edukator DM tipe 1.
Tujuan: Untuk membuat model pelatihan edukator DM Tipe 1 dan mengetahui efektifitas model pelatihan dalam membentuk kompetensi edukator DM tipe 1 pada anak.
Metode: Penelitian ini menggunakan metode mixed methods yang menggabungkan data kualitatif dan kuantitatif. Penelitian dilaksanakan dalam tiga tahap yaitu perencanaan dengan melakukan focus group discussion (FGD) atau diskusi kelompok terfokus, pelaksanaan pelatihan, dan evaluasi pelatihan dengan pendekatan Kirkpatrics.
Hasil: Pelatihan diikuti oleh 31 peserta dari 13 propinsi di Indonesia. Sebagian besar peserta (94,6%) puas dengan pelaksanaan pelatihan, terdapat peningkatan pengetahuan peserta dari nilai rata-rata pretest sebesar 71,6% menjadi 77,8% dan bermakna secara statistik dengan nilai p 0,00. Sebanyak 77,4% peserta lulus dalam ujian OSCE dengan tingkat kelulusan lebih dari 5 stasion. Umumnya peserta dapat menerapkan hasil pelatihan (92,8%) dan memberikan kontribusi nyata dan perbaikan terhadap organisasi (66,7%).
Kesimpulan: Telah terbentuk model pelatihan edukator DM tipe 1. Model pelatihan ini dapat membentuk kompetensi edukator diabetes berdasarkan reaksi peserta pelatihan, peningkatan pengetahuan dan keterampilan edukator diabetes, penerapan hasil pelatihan, dan kontribusi terhadap organisasi.

Background: Type 1 diabetes mellitus (DM) is a lifelong chronic illness which need professional multidiciplinnary approaches. Educators for diabetic patients are medical personnels who help these patients modify their life styles in order to achieve the optimum health status, by giving proper education to patients and their family. Currently, educators for type 1 DM in Indonesia are not available. An effective training model would be needed to create a good educator.
Objective: This study aimed to created a training model for type 1 DM educators and further to evaluate its effectiveness in building a competent type 1 DM educators for children.
Method: This is a mixed methods study which combined both qualitative and quantitative data. This study was done in three steps: (i) planning by doing a focus group discussion, (ii) training, and (iii) training evaluation with Kirkpatrics approach.
Result: Thirty one candidates from 13 province participated in this study. Most candidates (94,6%) were satisfied with the training program. The mean pre-post score were increased from 71,6% to 77,8%, statistically significant (p=0.00). About 77,4% candidates passed the OSCE examinations. Most candidates (92,8%) were able to implement the training program and gave real contribution for the organization progress (66,7%).
Conclusion: A new training model for type 1 DM educators has been established. This model is able to build a competent educators for DM. Evaluation was done based on the participan’s response during training, increase of knowledge and skill, and their implementation, and also their contribution for organization.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013
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UI - Tesis Membership  Universitas Indonesia Library
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Edenia Saumi
"Hiperglikemia merupakan gejala metabolik berupa peningkatan glukosa darah melebihi batas normal, yang dikaitkan dengan diabetes melitus (DM). Modifikasi gaya hidup yang lebih sehat, seperti dilakukannya restriksi kalori dengan metode fasting-mimicking diet (FMD) dapat dilakukan sebagai alternatif pendekatan untuk pengendalian DM tipe 2. Penelitian ini bertujuan untuk mengetahui pengaruh FMD berbahan nabati yang tersedia di Indonesia, terhadap kadar glukosa darah dan resistensi insulin. Penelitian dilakukan terhadap tikus jantan galur Sprague-Dawley model hiperglikemia yang dibagi menjadi 4 kelompok perlakuan (n=16), yakni kelompok hiperglikemia (high fat diet[HFD]-streptozotosin[STZ] 35 mg/kgBB dan CMC Na 0,5%), kelompok metformin (HFD-STZ 35 mg/kgBB dan metformin 250 mg/kgBB), kelompok FMD (HFD-STZ 35 mg/kgBB dan FMD), dan kelompok normal diet (ND) (CMC Na 0,5%). Pemberian perlakuan dilakukan selama 28 hari. Tikus dilakukan pengecekan glukosa darah puasa (GDP) dan berat badan setiap minggu perlakuan dan dikorbankan untuk diambil sampel darahnya setelah perlakuan berakhir. Homeostasis model assessment of insulin resistance (HOMA-IR) digunakan untuk mengukur resistensi insulin. Hasil penelitian menunjukkan penurunan kadar GDP dengan adanya pemberian FMD, walaupun tidak terdapat perbedaan signifikan antara GDP pra-perlakuan dengan GDP minggu ke-4 perlakuan (p>0,05). Hasil penelitian juga menunjukkan nilai HOMA-IR kelompok FMD mendekati nilai HOMA-IR kelompok ND dan lebih rendah secara signifikan dibandingkan nilai HOMA-IR kelompok hiperglikemia (p<0,05), yang berarti pemberian FMD pada tikus hiperglikemia menghasilkan tingkat resistensi insulin yang lebih rendah dibandingkan dengan tikus hiperglikemia yang tidak diberikan FMD. Sebagai kesimpulan, pemberian FMD dapat menurunkan GDP dan menghasilkan tingkat resistensi insulin yang lebih rendah pada tikus model hiperglikemia.

Hyperglycemia is a metabolic symptom in the form of an increase in blood glucose exceeding normal limits, which is associated with diabetes mellitus (DM). Healthy lifestyle modifications, such as calorie restriction with the fasting-mimicking diet (FMD) method, can be used as an alternative approach to controlling type 2 diabetes. This study aims to determine the effect of FMD using plant-based ingredients available in Indonesia on blood glucose levels and insulin resistance. The study was conducted on male rats of the Sprague-Dawley strain model of hyperglycemia, which were divided into 4 treatment groups (n = 16), namely the hyperglycemic group (high fat diet [HFD]-streptozotocin [STZ] 35 mg/kgBW and CMC Na 0.5%), the metformin group (HFD-STZ 35 mg/kgBW and metformin 250 mg/kgBW), the FMD group (HFD-STZ 35 mg/kgBW and FMD), and the normal diet (ND) group (CMC Na 0.5%). The treatment was carried out for 28 days. Rats were checked for fasting blood glucose (FBG) and body weight every week of treatment and sacrificed for blood samples after the treatment ended. Homeostasis model assessment of insulin resistance (HOMA-IR) was used to measure insulin resistance. The results showed a decrease in FBG levels with the administration of FMD, although there was no significant difference between pre-treatment FBG and FBG at the 4th week of treatment (p>0,05). The results also showed that the HOMA-IR value of the FMD group was close to the HOMA-IR value of the ND group and was significantly lower than the HOMA-IR value of the hyperglycemic group (p<0,05), which means that administering FMD to hyperglycemic rats resulted in lower levels of insulin resistance than the hyperglycemic rats that were not given FMD. In conclusion, administration of FMD can reduce FBG and result in lower levels of insulin resistance in hyperglycemic rats."
Depok: Fakultas Farmasi Universitas Indonesia, 2022
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UI - Skripsi Membership  Universitas Indonesia Library
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Saragih, Aditya Toga Sumondang
"Pendahuluan. Stress pembedahan merupakan faktor yang dapat mempengaruhi keluaran pasca pembedahan ortopedi, khususnya pada populasi diabetes mellitus tipe dua dimana regulasi glukosa sangat penting baik sebelum maupun pasca bedah. Kadar glukosa dan C-reactive protein merupakan biomarker yang akan meningkat bila terjadi stress pembedahan. Penelitian ini bertujuan untuk membandingkan kadar rerata glukosa dan C-reactive protein pada subjek penelitian dengan diberikan lidokain intravena dan kontrol pada operasi ortopedi.
Metode. Penelitian ini merupakan uji klinis acak tersamar yang mengikutsertakan 42 pasien yang menjalani pembedahan ortopedi. Sampel dilakukan pengelompokan dengan metode randomisasi menjadi dua kelompok. Kelompok pertama adalah pasien yang diberikan lidokain intravena selama pembedahan dalam anestesia umum. Kelompok kedua adalah pasien dalam anestesia umum tanpa lidokain. Pada kedua kelompok dilakukan dua kali pemeriksaan sampel glukosa dan C-reactive protein pada sebelum operasi dan sesudah operasi. Kedua kelompok dilakukan uji hipotesis untuk melihat perbedaan rerata glukosa dan C-reactive protein dengan analisa statistik menggunakan software SPSS.
Hasil. Tidak terdapat perbedaan bermakna antara rerata kadar glukosa dan C-reactive protein antara kelompok pasien dengan lidokain intravena dan kontrol. Rerata kadar glukosa pasca pembedahan lebih rendah pada kelompok lidokain dibandingkan kelompok kontrol, namun tidak berbeda bermakna (p>0.05). Tidak terdapat perbedaan rerata C-reactive protein pada kelompok lidokain dan kelompok kontrol (p>0.05).
Kesimpulan. Tidak terdapat perbedaan kadar glukosa dan C-reactive protein yang bermakna antara kelompok lidokain dan kelompok kontrol pada operasi ortopedi dalam anestesia umum pada populasi dengan diabetes mellitus tipe dua.

Introduction. Surgical stress is a factor that can influence orthopaedic postoperative outcomes, particularly in the type two diabetes mellitus population where blood sugar regulation is critical both before and after surgery. Blood sugar levels and C-reactive protein are biomarkers that will increase in the event of surgical stress. This study aimed to compare the average levels of blood sugar and C-reactive protein in study subjects with intravenous lidocaine and control in orthopaedic surgery.
Methods. The study was a randomized clinical trial that included 42 patients undergoing orthopaedic surgery. Samples were grouped by randomization method into two groups. The first group were patients who were given lidocaine intravenously during surgery under general anaesthesia. The second group is patients under general anaesthesia without lidocaine. In both groups, two blood sugar and c-reactive protein samples were examined before surgery and after surgery. Both groups tested the hypothesis to see the difference in average blood sugar and C-reactive protein with statistical analysis using SPSS software.
Results. There were no significant differences between mean blood sugar levels and C-reactive protein between the intravenous and control lidocaine groups. Average postoperative blood sugar levels were lower in the lidocaine group than in the control group, but not significantly different (p>0.05). There was no difference in mean C-reactive protein in the lidocaine group and the control group (p>0.05).
Conclusions. There were no significant differences in blood sugar and C-reactive protein levels between the lidocaine group and the control group in orthopaedic surgery under general anaesthesia in the population with type two diabetes mellitus.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Putri Wahyuningtias
"Prevalensi DM di Kota Bogor yakni sebesar 2,1% hal ini masih lebih tinggi dibandingkan dengan prevalensi DM di Indonesia menurut data Riskesdas 2013 yakni sebesar 2,0%. Tujuan penelitian ini adalah untuk mengetahui pengaruh aktivitas fisik terhadap kontrol kadar Glukosa darah penderita diabetes mellitus tipe 2 pada studi kohort PTM di Kota Bogor tahun 2011-2016. Menurut uji Log-rank survival berdasarkan aktivitas fisik tidak berbeda bermakna dengan nilai signifikansi 0,941. Bahwa survival antara kelompok aktivitas fisik cukup dan kurang tidak berbeda survival-nya terhadap event kontrol glukosa darah buruk. Penderita DM tipe 2 yang cukup beraktivitas fisik memiliki HR sebesar 0,788 kali (95%CI: 0,456-1,360) dengan p value 0,392. Artinya, penderita DM tipe 2 yang cukup beraktifitas fisik maupun yang kurang tidak menunjukkan perbedaan yang bermakna terhadap kontrol glukosa darah. Tidak ditemukan pengaruh aktivitas fisik terhadap kontrol Glukosa darah penderita diabetes mellitus tipe 2 pada studi kohort PTM di Kota Bogor tahun 2011-2016. Hal ini dikarenakan banyak terjadi sensor dan lost to follow up juga titik pengamatan yang cukup jauh rentangnya yakni 2 tahun. Diperlukan upaya promosi kesehatan yang berkelanjutan dan bagi peneliti lain dapat melakukan studi dengan titik pengamatan dengan rentang waktu yang lebih singkat agar efek dari aktivitas fisik terhadap kontrol glukosa darah penderita DM tipe 2 dapat diukur lebih tepat.

The prevalence of DM in Bogor City which is equal to 2.1%, this is still higher than the prevalence of DM in Indonesia according to Riskesdas 2013 data which is equal to 2.0%. The purpose of this study was to determine the effect of physical activity on blood glucose level control in patients with type 2 diabetes mellitus in the PTM cohort study in Bogor City in 2011-2016. According to the Log-rank survival test based on physical activity there was no significant difference with a significance value of 0.941. That survival between groups of physical activity is sufficient and the survival of the blood glucose control event is not different. Patients with type 2 DM who have enough physical activity have HR of 0.788 times (95% CI: 0.456-1.360) with p value 0.392. That is, patients with type 2 diabetes who have sufficient physical activity or those who do not show significant differences in blood glucose control. There was no effect of physical activity on blood glucose control in patients with type 2 diabetes mellitus in the PTM cohort study in Bogor City in 2011-2016. This is because there are a lot of sensors and lost to follow-up as well as a far enough observation point, which is 2 years. Continuous health promotion efforts are needed and other researchers can conduct studies with observation points with a shorter time span so that the effects of physical activity on blood glucose control in patients with type 2 diabetes can be measured more precisely."
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2018
T52263
UI - Tesis Membership  Universitas Indonesia Library
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Anisa Setya Sari
"Penyakit Diabetes Mellitus (DM) tipe 1 saat ini semakin banyak dialami oleh anak. Prinsip perawatan anak yang berfokus family centered care menuntut orang tua untuk aktif berperan serta dalam mengelola DM tipe 1 pada anak. Penelitian dilakukan dengan tujuan mengeksplorasi pengalaman orang tua dalam merawat anak DM tipe 1. Desain penelitian menggunakan fenomenologi deskriptif yang melibatkan 7 orang tua sebagai partisipan.
Hasil eksplorasi didapatkan 8 tema, yaitu:
1) tiga fase perubahan respon orang tua,
2) dua fase perubahan respon anak yang dirasakan orang tua,
3) aktivitas orang tua dalam mengelola DM tipe 1 pada anak,
4) penilaian orang tua terhadap pengobatan dengan insulin dan herbal,
5) pola komunikasi dan ketrampilan yang ditunjukkan mempengaruhi persepsi orang tua terhadap tenaga kesehatan,
6) dukungan sosial sebagai salah satu faktor yang mempengaruhi keberhasilan dalam mengelola DM tipe 1 pada anak,
7) perubahan yang dialami orang tua sebagai perawat utama anak, dan
8) harapan orang tua terhadap anak, dirinya sendiri dan tenaga kesehatan.
Kesimpulan yang didapatkan yaitu kemampuan orang tua dalam berespon adaptif berpengaruh terhadap pengelolaan DM tipe 1 secara efektif pada anak. Selanjutnya perlu dilakukan eksplorasi kemampuan anak dalam beradaptasi terhadap DM tipe 1 untuk memberikan pemahaman dari segi individu yang mengalami penyakit secara langsung.

Type 1 Diabetes Mellitus (DM) is now increasingly experienced by children. The principle of family centered care requires parents to actively participate in managing diabetes in children and the factors that influence it. Research conducted with the aim to explore the experience of parents in caring for children with type 1 DM. Descriptive phenomenology used in this research design by involving seven parents as participants.
The exploration resulted 8 themes, there are:
1) three-phases of parent?s response,
2) two-phases of children?s response perceived by parents,
3) the activity of parents in managing type 1 DM in children,
4) perception of parents to insulin and herbs,
5) communication patterns and skills shown affected the perception of parents towards health professionals,
6) social support as factor that influence the success in managing type 1 diabetes in children,
7) the changes of lifestyle which experienced by parents as primary caregivers of children, and
8) the expectations of parents of children, themselves and health professionals.
The conclusion is the ability of parents to respond adaptively influence the effectiveness of managing type 1 DM in children. Further exploration about children's adaption to type 1 DM is necessary to provide an understanding from the individual who experience it directly."
Depok: Universitas Indonesia, 2016
T46359
UI - Tesis Membership  Universitas Indonesia Library
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"Diabetes mellitus is comma only hereditary metabolic disorder. The signs were hyperglycemic and glucosuric with or without acute or chronic clinically symptoms. It was cause effectively insulin deficiency. The primary was carbohydrate metabolism disorder which followed lipid and protein metabolism disorders. The increase of blood. Glucose concentration could increcesing salivary glucose concentration. Glucose was a good media for the growth of microorganism, for example: candida albicans. The most frequently infection on oral mucous diabetes mellitus patients was candidacies. The purpose of the study was to determine the relation of blood glucose concentration and C. albicans griwth on oral cavity diabetes mellitus patients. The subject consisted of 8 non regulated diabetes mellitus, 8 regulated diabetes mellitus, and 8 normal patients, respectively. The assessment of blood glucose concentration used Bio-Rad Diastat Halmoglobine AIC method. The growth of C. albicans was determined using swab on oral mucous. The result of swab was into culated on sabaurond agar, than gram sainning and glucose test was done. Data was analyzed using speaman test. The result indicated thet the growth of C. albicans was eughen on non regulated diabetes mellitus than regulated diabetes mellitus. It's also on regulated diabetes mellitus that normal patient."
[Fakultas Kedokteran Gigi Universitas Jember, Journal of Dentistry Indonesia], 2007
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Artikel Jurnal  Universitas Indonesia Library
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Neneng Kurniawati
"Kontrol gula darah dipengaruhi oleh banyak hal, salah satunya adalah tingkat stres. Dalam penatalaksanaan diabetes melitus komponen intervensi untuk menurunkan stres terabaikan. Terapi progressive muscle relaxation (PMR) diketahui mampu mengontrol kadar gula darah
yang merupakan salah satu bagian dari intervensi keperawatan. Tujuan penelitian adalah untuk mengetahui pengaruh latihan PMR terhadap tingkat stres dan kadar gula darah sewaktu pada pasien diabetes melitus tipe 2. Metode penelitian ini adalah kuasi eksperimen dengan
desain pre and post test with control group. Masing-masing kelompok terdiri dari 18 responden. Pengambilan sampel dilakukan dengan consecutive sampling. Kelompok intervensi diberikan latihan PMR 2 kali sehari selama 3 hari. Kadar gula darah sewaktu diambil melalui pembuluh darah kapiler. Tingkat stres diukur menggunakan kuesioner depression anxiety stress scale (DASS) yang telah dimodifikasi menjadi 7 item. Hasil penelitian menunjukan bahwa terdapat pengaruh latihan PMR terhadap tingkat stres pada kelompok intervensi dengan nilai p didapat 0,0001. Pada penelitian ini pula didapatkan
adanya perubahan yang bermakna kadar gula darah sewaktu pada kelompok intervensi dan kelompok kontrol. Namun pada kedua kelompok tidak berbeda bermakna dengan pvalue 0,448 (p>0,05). Kesimpulan dari peneliian ini adalah latihan PMR berpengaruh secara signifikan terhadap tingkat stres pada pasien diabetes melitus tipe 2 pada kelompok intervensi akan tetapi tidak terdapat perbedaan yang bermakna pada kadar gula darah sewaktu antar kedua kelompok.

Blood glucose control is influenced by many factors, one of which is the level of stress. In the
management of diabetes mellitus component interventions to reduce stress neglected. Treatment of progressive muscle relaxation (PMR) is known to control blood sugar levels which is one part of nursing interventions. The research objective was to determine the effect of PMR on the level of stress and blood glucose levels in patients with type 2 diabetes mellitus. Methods This study applied a quasi experimental design with a pre and post test control group. Each group consisted of 18 respondents. Purposive sampling technique was used in this study. PMR exercise intervention group was given twice a day for 3 days. Blood sugar levels when taken through the capillaries. Stress levels were measured using a questionnaire depression anxiety stress scales
(DASS) which has been modified to 7 items, to measure stress levels. The results shows that there is a significant effect of PMR exercise on the level of stress in the intervention group with a p value of 0.0001, found also the presence of significant changes in blood glucose levels in the intervention group and the control group. But, the two groups did not differ significantly with p value 0.448 (p> 0.05). This study concludes that PMR exercises significant has a significant effect on stress levels in patients with type 2 diabetes mellitus intervention group and there is no significant difference on blood glucose levels between the two groups.
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Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2015
T47036
UI - Tesis Membership  Universitas Indonesia Library
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Putri Melisa Duha
"Penyakit metabolik yang sering ditemukan di usia kanak – kanak adalah Diabetes Melitus (DM) tipe 1 dengan defisiensi insulin yang diakibatkan oleh penghancuran sel beta pankreas sehingga meningkatkan kebutuhan metabolisme dan menyebabkan resiko anak mengalami fatigue. Penelitian ini bertujuan untuk menganalisis faktor dominan yang mempengaruhi fatigue pada anak dengan DM tipe 1. Penelitian ini menggunakan cross sectional design dengan melibatkan 233 responden yang dipilih menggunakan non probabilty: consecutive sampling. Hasil penelitian menunjukkan adanya hubungan yang bermakna antara fatigue dengan usia (p value= 0,011), lama didiagnosis (p value= 0,011), gangguan tidur (p value= 0,000), kecemasan (p value= 0,000), dan depresi (p value= 0,000) serta faktor yang paling besar mempengaruhi fatigue pada anak dengan DM tipe 1 adalah gangguan tidur. Hasil penelitian dapat digunakan sebagai asuhan keperawatan khususnya dalam memberikan pendidikan kesehatan untuk menurunkan gejala fatigue.

Metabolic disease that often found in children is type 1 diabetes mellitus with insulin deficiency which caused by the destruction of pancreatic beta cells, thereby increasing metabolic needs and causing the child’s fatigue risk. This study aims to analyze the dominant factors that affect fatigue in children with type 1 diabetes mellitus. This study used cross sectional design involving 233 respondents selected by non-probabilty: consecutive sampling. The results showed a meaningful relationship between fatigue and age (p value = 0.011), length of diagnosis (p value = 0.011), sleep disorders (p value = 0.000), anxiety (p value = 0.000), depression (p value = 0.000) and the factor that affects fatigue the most in children with type 1 diabetes mellitus is sleep disorders. The results of the study can be used as nursing care, especially in providing health education to reduce fatigue symptoms."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2022
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UI - Tesis Membership  Universitas Indonesia Library
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Walewangko, Olivia Cicilia
"Latar Belakang: Diabetes Melitus tipe 1 DMT1 merupakan penyakit kronis terbanyak yang membutuhkan pindah kelola dari anak ke dewasa. Sementara itu, penyandang DMT1 yang menjalani pindah kelola menunjukkan kendali glukosa darah yang buruk dan peningkatan risiko hospitalisasi. Profil dan faktor-faktor yang memengaruhi kendali glukosa darah penyandang DMT1 usai transisi di Indonesia belum diketahui.
Tujuan: Mendapatkan profil pencapaian target HbA1c dan faktor-faktor yang memengaruhinya pada penyandang DMT1 usia transisi.
Metode: Penelitian ini merupakan studi observasional potong lintang yang dilakukan pada 108 subyek DMT1 berusia 16-30 tahun. Data karakteristik subyek, Pemeriksaan Gula Darah Mandiri PGDM , status depresi dan ketersediaan asuransi kesehatan didapat dari anamnesis. Kadar HbA1c diperiksa dengan metode High Performance Liquid Chromatography HPLC . Hubungan antara faktor-faktor yang berhubungan dengan HbA1c dianalisis secara bivariat dengan chi square dan multivariat dengan regresi logistik menggunakan Statistical Package for the Social Sciences SPSS versi 21.0
Hasil: Seratus delapan subyek yang direkrut dalam penelitian ini memiliki rerata usia 20,89 SB 4,87 tahun dan rerata HbA1c 9,02 SB 2,13 . Sebanyak 58,35 subjek melakukan PGDM le;60 kali/bulan, 88 subjek telah memiliki asuransi kesehatan dan 70,4 subjek mengalami depresi minimal dengan rerata skor Beck Depression Inventory BDI adalah 11,31 9,32. Proporsi penyandang DMT1 usia transisi yang mencapai target HbA1c pada adalah sebesar 20,4 . Analisis bivariat dan multivariat menunjukkan tidak ada hubungan yang bermakna antara usia p=0,639 , frekuensi PGDM p=0,170 , status depresi p=0,069 , dan asuransi kesehatan p=1,000 dengan pencapaian target HbA1C pada populasi ini.
Simpulan: Proporsi pencapaian target HbA1c pada pasien DMT1 usia transisi cukup rendah. Pada penelitian ini usia, frekuensi PGDM, depresi dan cakupan asuransi kesehatan tidak berhubungan dengan tercapainya target HbA1c.

Backgrounds: Type 1 Diabetes Mellitus T1DM is a chronic disease that requires transfer from pediatric to adult clinic. This group of population who underwent a transfer period experience poor blood glucose control and an increased risk of hospitalization, yet factors contributing to HbA1c target achievement in T1DM adolescent and young person is known.
Objective: To Obtain a profile of HbA1c target achievement and factors correlate to it in adolescent and young person with T1DM.
Methods: It is a cross sectional study including of 108 adolescent and young adults with T1DM, with ranges of age between 16 to 30 years old. Subject's characteristics, frequency of Self Monitoring Blood Glucose SMBG , depression and health insurance data are obtained from anamnesis. HbA1c level is examined by High Performance Liquid Chromatography HPLC method. The correlation between factors related to HbA1c was analysed bivariate with chi square and multivariate with logistic regression.
Results: Out of 108 subjects recruited in this study the median age is 20,89 SB 4,87 years old and HbA1C 9,02 SB 2,13 . Around 58,35 subject do the SMBG le 60 times month, 88 subject have health insurance, the mean Beck Depression Inventory BDI score is 11,31 9,32 in which 70,4 had minimal depression. HbA1c target achievement is 20,4 . Bivariate and multivariate analysis result in no significantly difference between age p 0,639 , SMBG frequency p 0,170 , depression p 0,069 , health insurance p 1,000 and HbA1c target achievement in adolescent and young person with T1DM.
Conclusions: The proportion of HbA1c target achievement in adolescent and young person with T1DM quite low. This study showed no statistically significant correlation between age, SMBG frequency, depression, health insurance and HbA1c target achievement in adolescent and young person with T1DM.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Laurentius A. Pramono
"ABSTRAK
Latar Belakang. Prevalensi disfungsi tiroid lebih tinggi pada pasien diabetes dibandingkan populasi
umum. Hipotiroidisme memperburuk komplikasi, morbiditas, mortalitas, dan kualitas hidup pasien
diabetes melitus tipe 2 (DM tipe 2). Faktor risiko hipotiroidisme pada pasien DM tipe 2 selama ini masih
kontradiktif dan belum dikaji secara lengkap. Keberadaan sistem skor hipotiroidisme pada pasien DM
tipe 2 diperlukan untuk membantu diagnosis dan menapis pasien DM tipe 2 yang memerlukan
pemeriksaan laboratorium fungsi tiroid sebagai baku emas diagnosis hipotiroidisme.
Tujuan. Mengetahui prevalensi dan determinan hipotiroidisme pada pasien DM tipe 2.
Metode. Penelitian dengan desain potong lintang dilakukan di Poliklinik Divisi Metabolik Endokrin
(Poliklinik Diabetes) RSCM pada Juli sampai September 2015 dengan metode sampling konsekutif.
Subjek menjalani anamnesis, pemeriksaan fisis, dan pemeriksaan laboratorium (TSH dan fT4). Analisis
data dilakukan dengan program statistik SPSS Statistics 17.0 untuk analisis univariat, bivariat,
multivariat, dan Receiving Characteristics Operator (ROC) dan SPSS Statistics 20.0 untuk analisis
bootstrapping pada Kalibrasi Hosmer-Lemeshow.
Hasil. Sebanyak 303 subjek dianalisis untuk mendapatkan proporsi disfungsi tiroid dan 299 subjek
dianalisis untuk mendapatkan determinan hipotiroidisme. Sebanyak 23 subjek (7,59%) terdiagnosis
hipotiroidisme, terdiri dari 43,5% subjek hipotiroid klinis dan 56,5% subjek hipotiroid subklinis
berdasarkan Indeks Zulewski dan/atau Indeks Billewicz, dengan 16,7% hipotiroid klinis dan 83,3%
hipotiroid subklinis berdasarkan hasil pemeriksaan fT4. Determinan hipotiroidisme pada pasien DM
tipe 2 adalah riwayat penyakit tiroid di keluarga dengan OR sebesar 4,719 (95% Interval
Kepercayaan/IK 1,07-20,8, p = 0,04), keberadaan goiter dengan OR sebesar 20,679 (95% IK 3,49122,66, p = 0,001),
kontrol glikemik yang buruk dengan OR sebesar 3,460 (95%
IK 1,075-11,14, p = 0,037), dan adanya sindrom metabolik
OR sebesar 25,718 (95% IK 2,21-299,99, p = 0,01). Simpulan. Proporsi hipotiroidisme pada pasien DM tipe 2 adalah 7,59%. Determinan diagnosis dan komponen sistem skor hipotiroidisme pada pasien DM tipe 2 adalah riwayat penyakit tiroid di keluarga, keberadaan goiter, kontrol glikemik yang buruk, dan adanya sindrom metabolik. Sistem skor yang diberi nama Skor Hipotiroid RSCM ini diharapkan menjadi alat bantu diagnosis hipotiroidisme pada pasien
DM tipe 2.
ABSTRACT
Background. Prevalence of thyroid dysfunction is greater in diabetes patients compared to general
population. Hypothyroidism is worsening complications, morbidity, mortality, and quality of life in type
2 diabetes mellitus (T2DM) patients. Risk factors of hypothyroidism in T2DM patients are still
contradictive and not assessed completely. Presence of scoring system to estimate hypothyroidism in
T2DM patients are needed to help diagnosing and screening of T2DM patients who need to undergo
thyroid function test as a gold standard diagnostic for hypothyroidism.
Aim. To identify prevalence and estimators of hypothyroidism in T2DM patients.
Methods. A cross-sectional study was conducted in Metabolic Endocrine (Diabetes) Outpatient Clinic
Cipto Mangunkusumo Hospital from July-September 2015 with consecutive sampling method. All
subjects underwent interview, physical examination, and laboratory testing (TSH and fT4). Analysis
was done by using SPSS Statistics 17.0 for univariate, bivariate, multivariate, and ROC (Receiving
Operator Characteristics) analysis and SPSS Statistics 20.0 for bootstrapping analysis in HosmerLemeshow
Calibration. Results. 303 subjects included for proportion study of thyroid dysfunction and 299
subjects included for analysis of hypothyroidism determinants. 23 subjects (7,59%) are diagnosed as having
hypothyroidism, consisted of 43,5% clinical hypothyroidism and 56,5% subclinical hypothyroidism
based on clinical scoring index by Zulewski and Billewicz, and 16,7% subjects as having clinical
hypothyroidism and 83,3% subjects as having subclinical hypothyroidism based on fT4 examination.
Determinants for hypothyroidism in T2DM patients are family history of thyroid disease with OR 4,719
(95% Confident Interval/CI 1,07-20,8, p = 0,04), having goiter or difus struma with OR 20,679 (95%
CI 3,49-122,66, p = 0,001), poor glycemic control with OR 3,460 (95% CI 1,075-11,14, p = 0,037), and
metabolic syndrome with OR 25,718 (95% CI 2,21-299,99, p = 0,01). Conclusion. Proportion of hypothyroidism in T2DM patients is 7,59%. Determinants and components
of scoring system of hypothyroidism in T2DM patients consist of family history of thyroid disease,
having goiter or difus struma, poor glycemic control, and metabolic syndrome. Scoring system which is
called RSCM Hypothyroid Score is expected to be a tool for helping diagnosis of hypothyroidism in
T2DM patients.;Background. Prevalence of thyroid dysfunction is greater in diabetes patients compared to general
population. Hypothyroidism is worsening complications, morbidity, mortality, and quality of life in type
2 diabetes mellitus (T2DM) patients. Risk factors of hypothyroidism in T2DM patients are still
contradictive and not assessed completely. Presence of scoring system to estimate hypothyroidism in
T2DM patients are needed to help diagnosing and screening of T2DM patients who need to undergo
thyroid function test as a gold standard diagnostic for hypothyroidism.
Aim. To identify prevalence and estimators of hypothyroidism in T2DM patients.
Methods. A cross-sectional study was conducted in Metabolic Endocrine (Diabetes) Outpatient Clinic
Cipto Mangunkusumo Hospital from July-September 2015 with consecutive sampling method. All
subjects underwent interview, physical examination, and laboratory testing (TSH and fT4). Analysis
was done by using SPSS Statistics 17.0 for univariate, bivariate, multivariate, and ROC (Receiving
Operator Characteristics) analysis and SPSS Statistics 20.0 for bootstrapping analysis in HosmerLemeshow
Calibration.
Results.
303
subjects
included
for
proportion
study
of
thyroid
dysfunction
and
299
subjects
included
for
analysis of hypothyroidism determinants. 23 subjects (7,59%) are diagnosed as having
hypothyroidism, consisted of 43,5% clinical hypothyroidism and 56,5% subclinical hypothyroidism
based on clinical scoring index by Zulewski and Billewicz, and 16,7% subjects as having clinical
hypothyroidism and 83,3% subjects as having subclinical hypothyroidism based on fT4 examination.
Determinants for hypothyroidism in T2DM patients are family history of thyroid disease with OR 4,719
(95% Confident Interval/CI 1,07-20,8, p = 0,04), having goiter or difus struma with OR 20,679 (95%
CI 3,49-122,66, p = 0,001), poor glycemic control with OR 3,460 (95% CI 1,075-11,14, p = 0,037), and
metabolic syndrome with OR 25,718 (95% CI 2,21-299,99, p = 0,01).
Conclusion. Proportion of hypothyroidism in T2DM patients is 7,59%. Determinants and components
of scoring system of hypothyroidism in T2DM patients consist of family history of thyroid disease,
having goiter or difus struma, poor glycemic control, and metabolic syndrome. Scoring system which is
called RSCM Hypothyroid Score is expected to be a tool for helping diagnosis of hypothyroidism in
T2DM patients.
;Background. Prevalence of thyroid dysfunction is greater in diabetes patients compared to general
population. Hypothyroidism is worsening complications, morbidity, mortality, and quality of life in type
2 diabetes mellitus (T2DM) patients. Risk factors of hypothyroidism in T2DM patients are still
contradictive and not assessed completely. Presence of scoring system to estimate hypothyroidism in
T2DM patients are needed to help diagnosing and screening of T2DM patients who need to undergo
thyroid function test as a gold standard diagnostic for hypothyroidism.
Aim. To identify prevalence and estimators of hypothyroidism in T2DM patients.
Methods. A cross-sectional study was conducted in Metabolic Endocrine (Diabetes) Outpatient Clinic
Cipto Mangunkusumo Hospital from July-September 2015 with consecutive sampling method. All
subjects underwent interview, physical examination, and laboratory testing (TSH and fT4). Analysis
was done by using SPSS Statistics 17.0 for univariate, bivariate, multivariate, and ROC (Receiving
Operator Characteristics) analysis and SPSS Statistics 20.0 for bootstrapping analysis in HosmerLemeshow
Calibration.
Results.
303
subjects
included
for
proportion
study
of
thyroid
dysfunction
and
299
subjects
included
for
analysis of hypothyroidism determinants. 23 subjects (7,59%) are diagnosed as having
hypothyroidism, consisted of 43,5% clinical hypothyroidism and 56,5% subclinical hypothyroidism
based on clinical scoring index by Zulewski and Billewicz, and 16,7% subjects as having clinical
hypothyroidism and 83,3% subjects as having subclinical hypothyroidism based on fT4 examination.
Determinants for hypothyroidism in T2DM patients are family history of thyroid disease with OR 4,719
(95% Confident Interval/CI 1,07-20,8, p = 0,04), having goiter or difus struma with OR 20,679 (95%
CI 3,49-122,66, p = 0,001), poor glycemic control with OR 3,460 (95% CI 1,075-11,14, p = 0,037), and
metabolic syndrome with OR 25,718 (95% CI 2,21-299,99, p = 0,01).
Conclusion. Proportion of hypothyroidism in T2DM patients is 7,59%. Determinants and components
of scoring system of hypothyroidism in T2DM patients consist of family history of thyroid disease,
having goiter or difus struma, poor glycemic control, and metabolic syndrome. Scoring system which is
called RSCM Hypothyroid Score is expected to be a tool for helping diagnosis of hypothyroidism in
T2DM patients.
"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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