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"Indonesian Journal of Dentistry 2006; Edisi Khusus KPPIKG XIV: 312-315The association between diabetic sialosis and salivary gland function has not been clearly stated. The objective of this study is to assess the association between sialosis and salivary flow rates and xerostomia in type 2 diabetic patients. Eighty one subjects enrolled in this cross-sectional study, consisted of 50 type 2 diabetic outpatients of RSUPN Ciptomangunkusumo (mean of age: 60,96±8,38) and 31 control subjects (mean of age: 57,03±10). Clinical examination was performed to assess sialosis. Unstimulated and stimulated salivary flow rates were measured using spitting method. Saliva secretion was stimulated using 2 % citric acid. Xerostomia was assessed using xerostomia questionnaire. The result showed that sialosis was found only in diabetic group, with a percentage of 28% (14 out of 50). This finding was not found in the well-controlled diabetic group. The mean of unstimulated and stimulated salivary flow rates of the patients with diabetic sialosis were lower than that of the diabetic patients without sialosis. Statistic analysis showed significant association between sialosis and unstimulated salivary flow rate (p=0,001) and between sialosis and xerostomia (p=0,005), but there was no significant association between sialosis and stimulated salivary flow rate (p=0.105). It is concluded that there are significant associations between sialosis and the decrease of unstimulated salivary flow rate, and between sialosis and xerostomia. Therefore patients with diabetic sialosis should be examined periodically to find out the possibility of salivary gland function disorder. "

"ABSTRAKDiabetes Melitus merupakan penyakit tidak menular penyebab kematian terbesar keempat di dunia. Depok menduduki peringkat 2 di Jawa Barat dengan jumlah penderita diabetes mellitus tipe 2 terbanyak. Insulin direkomendasikan sebagai salah satu terapi diabetes lini pertama untuk mengontrol kadar glukosa. Oleh karena itu, penting untuk mengetahui tingkat kepatuhan terapi insulin pada penderita diabetes mellitus tipe 2 agar tercapai hasil terapi sesuai dengan yang direncanakan. Penelitian ini bertujuan untuk mengidentifikasi gambaran kepatuhan terapi insulin pada penderita diabetes mellitus tipe 2 di Kota Depok. Penelitian ini merupakan penelitian kuantitatif dengan menggunakan desain penelitian model cross sectional dan menggunakan teknik consecutive sampling sebagai teknik dalam pengambilan sampel. Jumlah sampel 79 orang pasien diabetes mellitus tipe 2 yang berobat ke Rumah Sakit Umum Daerah Kota Depok. Berdasarkan hasil penelitian didapatkan kepatuhan insulin masih rendah sebanyak 52 orang 65,8 . Adanya penelitian ini, diharapkan dapat memberikan informasi kepada Rumah Sakit Umum Daerah Kota Depok, Dinas Kesehatan Depok, perawat, dan masyarakat untuk meningkatkan kepatuhan terapi insulin.

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ABSTRAKAbstract Diabetes Mellitus is the fourth leading non infectious diseases cause of death in the world. Depok was ranked 2nd in West Java with the highest number of people with type 2 diabetes mellitus. Insulin is recommended as one of the first line diabetes therapy to control glucose levels. Therefore, it is important to know the adherence level of insulin therapy in people with type 2 diabetes mellitus in order to achieve the satisfied results of therapy. This study aimed to identify the level of adherence in insulin therapy among people with type 2 diabetes mellitus in Depok City. This research was a quantitative research using a cross sectional design and using consecutive sampling as a technique in sampling. The number of samples were 79 patients with type 2 diabetes mellitus who came to the Regional General Hospital of Depok City. The result showed that the level of insulin adherence came still low as many as 52 people 65.8 . This study is expected to provide information to the Regional General Hospital of Depok City, Depok Health Office, nurses, and the community to improve adherence to insulin therapy."

"Latar Belakang: Penyakit tidak menular diketahui menjadi penyebab 41 juta kematian di dunia setiap tahunnya. Diabetes merupakan satu dari empat jenis utama penyakit tidak menular di seluruh dunia. Pada tahun 2018, Kota Depok memiliki prevalensi diabetes melitus sebesar 2,17% dan menjadi kabupaten/kota dengan prevalensi diabetes melitus tertinggi kedua di Jawa Barat. Tujuan: Mengetahui faktor-faktor yang berhubungan dengan kejadian diabetes melitus tipe 2 pada penduduk Kota Depok tahun 2023. Metode: Penelitian ini merupakan penelitian kuantitatif dengan desain studi cross-sectional. Data yang digunakan merupakan data sekunder yang diperoleh dari Sistem Informasi Penyakit Tidak Menular (SIPTM) Kota Depok tahun 2023 dan dilakukan analisis univariat serta bivariat menggunakan uji chi-square. Variabel independen terdiri dari faktor sosiodemografis (usia, jenis kelamin, riwayat diabetes keluarga, obesitas, obesitas sentral, dan hipertensi) serta faktor perilaku (merokok, kurang aktivitas fisik, kurang konsumsi sayur buah, konsumsi alkohol, dan konsumsi gula berlebih). Hasil: Hasil penelitian ini menunjukkan adanya prevalensi diabetes melitus tipe 2 sebesar 21,9% pada penduduk Kota Depok tahun 2023. Faktor-faktor yang berhubungan dengan kejadian diabetes melitus tipe 2 adalah usia > 45 tahun (POR 1,225; 95% CI: 1,197—1,254), jenis kelamin laki-laki (POR 1,379; 95% CI: 1,347— 1,411), memiliki riwayat diabetes keluarga (POR 0,297; 95% CI: 0,267—0,330), obesitas (POR 1,524; 95% CI: 1,487—1,562), obesitas sentral (POR 0,908; 95% CI: 0,886—0,930), hipertensi (POR 0,500; 95% CI: 0,488—0,511), merokok (PR 1,289; 95% CI: 1,244—1,335), kurang aktivitas fisik (POR 1,218; 95% CI: 1,189—1,247), kurang konsumsi sayur buah (POR 0,846; 95% CI: 0,812—0,881), dan konsumsi gula berlebih (POR 1,879; 95% CI: 1,828–1,932). Sedangkan, faktor konsumsi alkohol tidak terbukti memiliki hubungan dengan kejadian diabetes melitus tipe 2. Kesimpulan: Faktor sosiodemografis dan perilaku terbukti memiliki hubungan yang bermakna dengan kejadian diabetes melitus tipe 2. Penelitian ini diharapkan dapat menjadi pertimbangan untuk pembuatan program pencegahan dan pengendalian diabetes melitus tipe 2 sehingga dapat menurunkan prevalensi diabetes di Kota Depok.

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Background: Non-communicable diseases (NCDs) are known to cause 41 million deaths globally each year. Diabetes is one of the four major types of NCDs worldwide. In 2018, the city of Depok had a diabetes mellitus prevalence of 2.17%, making it the second-highest prevalence of diabetes mellitus in West Java. Objective: To identify the factors associated with type 2 diabetes mellitus among the residents of Depok City in 2023. Methods: This study is a quantitative research with a cross-sectional study design. The data used are secondary data obtained from the Non-Communicable Disease Information System (SIPTM) of Depok City in 2023 and analyzed using univariate and bivariate analysis with the chi-square test. Independent variables include sociodemographic factors (age, gender, family history of diabetes, obesity, central obesity, and hypertension) as well as behavioral factors (smoking, lack of physical activity, insufficient consumption of vegetables and fruits, alcohol consumption, and excessive sugar consumption). Results: This study showed a prevalence of type 2 diabetes mellitus of 21.9% among the residents of Depok City in 2023. The factors associated with the incidence of type 2 diabetes mellitus are age > 45 years (POR 1.225; 95% CI: 1.197—1.254), male gender (POR 1.379; 95% CI: 1.347—1.411), having a family history of diabetes (POR 0.297; 95% CI: 0.267—0.330), obesity (POR 1.524; 95% CI: 1.487—1.562), central obesity (POR 0.908; 95% CI: 0.886—0.930), hypertension (POR 0.500; 95% CI: 0.488—0.511), smoking (POR 1.289; 95% CI: 1.244—1.335), lack of physical activity (POR 1.218; 95% CI: 1.189—1.247), insufficient consumption of vegetables and fruits (PR 0.846; 95% CI: 0.812—0.881), and high sugar consumption (POR 1,879; 95% CI: 1,828–1,932. However, alcohol consumption was not proven to be associated with type 2 diabetes mellitus. Conclusion: Sociodemographic and behavioral factors are significantly associated with type 2 diabetes mellitus. This study is expected to serve as a consideration for the development of prevention and control programs for type 2 diabetes mellitus to reduce the prevalence of diabetes in Depok City."

"Tingginya prevalensi diabetes mellitus tipe 2 dan makanan khas daerah yang mengandung cukup banyak lemak menyebabkan peningkatan resiko peripheral arterial disease di Kota Palu. Latihan Buerger Allen merupakan salah satu cara mencegah dan mengatasi penyakit ini. Akan tetapi, latihan tersebut kurang digunakan karena belum adanya penelitian terkait latihan ini yang dipublikasikan di Indonesia. Penelitian ini bertujuan untuk mengetahui pengaruh latihan ini terhadap sirkulasi perifer pada ekstremitas bawah pasien diabetes mellitus tipe 2. Penelitian ini merupakan quasi-experimental, model pretest?posttest nonequivalent control group dengan 24 responden. Latihan ini diberikan kepada kelompok perlakuan selama 4 hari, 3 kali sehari, 2 siklus latihan selama 22 menit. Hasil uji statistik menunjukkan ada perbedaan bermakna nilai ankle brachial index antara pretest dan posttest pada kelompok perlakuan (p = .047; α .05), sebaliknya tidak ada perbedaan yang bermakna pada kelompok kontrol (p = .083; α .05). Secara statistik disimpulkan bahwa ada perbedaan bermakna antara nilai ankle brachial index posttest kelompok perlakuan dengan kontrol (p = .045; α .05), sehingga disimpulkan latihan ini efektif meningkatkan sirkulasi arteri perifer ekstremitas bawah. Disarankan agar latihan ini diberikan kepada pasien diabetes mellitus tipe 2.

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Patient with diabetes mellitus have high risk of peripheral arterial disease. The risk increased on Palu City due to high prevalence of diabetes mellitus type 2 and food culture with high amount of fats. The Buerger-Allen exercise studies showed positive effect to improve lower extremity perfusion among patients with type 2 diabetes mellitus. However, this exercise gradually has been dropped in recent decades due to lack of published study in Indonesia. The study aimed to identify the effectiveness of this exercise to improve peripheral circulation of lower extremity. This study is the quasi-experimental with a pretest-posttest nonequivalent control group model, which enrolled 12 experimental and 12 control participants. Exercise had provided for 4 days, 3 times a day, and 2 cycles exercise for 22 minutes. The result showed significant difference of ankle-brachial index between the experiment and control group (p = .045; α .05). This study recommends Buerger-Allen exercise to be applied to patients with type 2 diabetes mellitus."

"Latar Belakang: Pencapaian target glikemik pada pasien DM tipe2 yang masih rendah khususnya di Indonesia mengakibatkan berbagai komplikasi termasuk gangguan fungsi kognitif.. Padahal untuk menerapkan manajemen mandiri pada pasien DM, dibutuhkan fungsi kognitif yang kompleks. Pada berbagai penyakit kronis, fungsi kognitif khususnya domain memori yang buruk telah dihubungkan dengan ketidakpatuhan penggunaan obat. Meskipun demikian, belum ada studi yang mencari hubungan keduanya pada pasien DM tipe 2.Tujuan: Mengetahui hubungan gangguan fungsi kognitif dengan ketidakpatuhan penggunaan obat pada pasien DM tipe 2Metodologi: Desain studi ini adalah potong lintang terhadap 96 subjek penelitian dengan DM tipe 2 berusia >18 tahun di unit rawat jalan RSUD Tebet. Karakteristik demografi, parameter klinis, penilaian fungsi kognitif, dan kepatuhan penggunaan obat didokumentasikan secara lengkap. Penilaian fungsi kognitif menggunakan Montreal Cognitive Assessment versi Indonesia (MoCA-Ina). Penilaian kepatuhan penggunaan obat dinilai menggunakan penghitungan pil. Studi ini menggunakan analisis distribusi frekuensi dan proporsi, analisis bivariat dengan uji Chi-Square.Hasil: Terdapat 69,8% subjek penelitian dengan gangguan fungsi kognitif dengan faktor tingkat pendidikan sebagai faktor yang mempengaruhi. Analisa mendapatkan kejadian penurunan fungsi domain memori 96,9%;, eksekutif 78%, visuospasial 78%; atensi 30%; bahasa 26%; dan orientasi 4,2%. Ketidakpatuhan penggunaan obat didapatkan pada 26% subjek penelitian. Analisa bivariat tidak menunjukkan adanya hubungan antara gangguan fungsi kognitif dengan ketidakpatuhan penggunaan obat (OR 0,757 95% CI [0,280-2,051] p=0,58).Kesimpulan: Gangguan fungsi kognitif didapatkan pada 69,8% pasien DM tipe 2, dan ketidakpatuhan ditemukan pada 26% pasien. Tidak ada hubungan yang didapatkan antara gangguan fungsi kognitif dengan ketidakpatuhan penggunaan obat pada pasien DM tipe 2

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Background: Poor glycemic control in Type 2 Diabetes Mellitus patients, especially in Indonesia, results in a variety of complications including a cognitive impairment. In fact, to implement self-management in DM patients, intact cognitive function is necessary. In a variety of chronic diseases, cognitive impairment, especially the memory domain has been associated with medication nonadherence. Nonetheless, no studies have looked for the relationship between the two in type 2 DM patients

Objective: This study aims to determine the relationship of cognitive impairment with medication nonadherence in type 2 DM patients.

Methodology: The design of this study was cross-sectional with 96 study subjects with type 2 DM, > 18 years old in the outpatient unit at RSUD Tebet. Demographic characteristics, clinical parameters, cognitive function assessment, and medication adherence use were fully documented. Cognitive function assessed with the Indonesian version of the Montreal Cognitive Assessment (MoCA-Ina). Medication adherence was assessed using pill count. This study uses the analysis of frequency and proportions distribution, and bivariate analysis with the Chi-Square test.

Results: There were 69.8% of the research subjects with cognitive impairment with education level as an associated factor. Analysis of the occurrence of impairment of the function of memory domain 96.9%; executive 78%, visuospatial 78%; attention 30%; language 26%; and 4.2% orientation. Oraal medication nonadherence was found in 26% of the study subjects. Bivariate analysis did not show an association between cognitive impairment and medication nonadherence (OR 0.757 95% CI [0.280-2.051] p=0.58).

Conclusion: Cognitive impairment was found in 69.8% Type 2 DM patients, and medication nonadherence was found in 26% patients. Cognitive impairment was not associated with medication nonadherence in type 2 DM patients"

"Pendahuluan –Diabetes Mellitus tipe 2 (DMT2) merupakan sindrom inflamasi progresif dengan peningkatan risiko komplikasi kardiovaskular berupa Atherosclerotic Cardiovascular Disease (ASCVD). Proses thromboinflamasi pada DMT2 ASCVD dikaitkan dengan perubahan pada jumlah serta fungsi leukosit dan trombosit. Rasio leukosit (Neutrophil-Lymphocyte Ratio, Monocyte-Lymphocyte Ratio, Platelet-Lymphocyte Ratio) serta penanda biologis dari netrofil (Peptydil Arginine Deiminase-4), monosit/makrofag (Interleukin-6), dan trombosit (Platelet Glycoprotein 1b-α) dikenali sebagai penanda biologis yang dapat memprediksi perubahan plak stabil dan tidak stabil pada pasien DMT2 ASCVD. Studi ini dilakukan untuk menganalisis hubungan antara klasifikasi pasien DMT2 2 risiko sangat tinggi (Very High Risk / VHR) dan risiko tinggi (High Risk / HR) dan pada pasien DMT2 dengan Acute Coronary Syndrome (ACS) terhadap parameter inflamasi NLR, MLR, PLR, GPIbα, PAD4, dan IL-6. Metodologi – 75 pasien DMT2 ACSVD yang menjalani pengobatan di rawat jalan dan unit gawat darurat Rumah Sakit Pusat Jantung dan Pembuluh Darah Harapan Kita dilibatkan dalam studi ini. Pasien dikategorikan sebagai DMT2 risiko tinggi, DMT2 risiko sangat tinggi, dan DMT2 ACS. Parameter metabolisme dan inflamasi diukur dan dianalisis pada ketiga kelompok DMT2 ASCVD tersebut. Hasil dan Diskusi – Nilai parameter metabolisme kolesterol total dan Low Density Lipoprotein (LDL) serta parameter inflamasi NLR, MLR, PLR, dan IL-6 ditemukan lebih tinggi dan signifikan pada kelompok DMT2 ACS. Nilai Gp1bα ektodomain (Glikokalisin) ditemukan lebih tinggi pada kelompok DMT2 risiko tinggi dan DMT2 risiko sangat tinggi menggambarkan hubungan Gp1bα dan ADAM17 yang terkait dengan keseimbangan pembentukan dan pembersihan trombosit. Nilai PAD4 yang lebih tinggi pada kelompok DMT2 risiko tinggi dan DMT2 risiko sangat tinggi menggambarkan proses perbaikan jaringan dan induksi polarisasi makrofag menjadi fenotip antiinflamasi yang berperan terhadap perbaikan fungsi kardiovaskular. Penelitian ini menunjukkan bahwa nilai NLR dan kolesterol total yang tinggi serta nilai PAD4 yang rendah merupakan prediktor terjadinya keadaan ACS (plak tidak stabil) pada pasien DMT2 ASCVD.

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Introduction – Diabetes Mellitus type 2 (T2DM) is a progressive inflammatory syndrome with an increased risk of cardiovascular complications in the form of Atherosclerotic Cardiovascular Disease (ASCVD). The thromboinflammatory process in T2DM ASCVD is associated with changes in the number and function of leukocytes and platelets. The leukocyte ratio (Neutrophil-Lymphocyte Ratio, Monocyte-Lymphocyte Ratio, Platelet-Lymphocyte Ratio) as well as biological markers of neutrophils (Peptydyl Arginine Deiminase-4), monocytes/macrophages (Interleukin-6), and platelets (Platelet Glycoprotein 1b-α) are recognized as a biological marker that can predict stable and unstable plaque changes in T2DM with ASCVD. This study was conducted to analyze the relationship between the classification of T2DM patients with very high risk (VHR), high risk (HR), and early onset ACS on the inflammatory parameters NLR, MLR, PLR, GPIbα, PAD4, and IL-6.

Methodology – This study included 75 ACSVD T2DM patients being treated at Harapan Kita Heart and Blood Vessel Center Hospital's outpatien and emergency unit. Patients were classified as having high risk T2DM, extremely high risk T2DM, or ACS T2DM. In the three T2DM ASCVD groups, metabolic and inflammatory parameters were evaluated and studied.

Results and Discussion – The metabolic indices total cholesterol and Low Density Lipoprotein (LDL), as well as the inflammatory markers NLR, MLR, PLR, and IL-6, were shown to be greater and significant in the T2DM ACS group. Gp1b ectodomain (Glycocalysin) values were found to be greater in the high risk T2DM and very high risk T2DM groups, demonstrating the relationship between Gp1b and ADAM17, which is associated to platelet production and clearance balance. Higher PAD4 values in the high risk T2DM and very high risk T2DM groups represent tissue repair and the activation of macrophage polarization into an anti-inflammatory phenotype, which contributes to improved cardiovascular function. According to this study, high NLR and total cholesterol levels, as well as low PAD4 levels, are predictors of ACS (unstable plaque) in ASCVD T2DM patients."

"Dental caries is a multifactorial disease. The most important factors in the development of caries is saliva. Reduced salivary secretion in patients with type 2 diabetes mellitus to the occurence of caries have yielded controversial results. The aim of the study was to find out whether the risk factors of the saliva, i.e. saliva secretion rate, buffer capacity, salivary S. mutans, salivary Lactobacilli, alone or in combination could be used for prediction of caries activity. Thirty patients with type 2 diabetes mellitus and age range 46-73 participated. Diabetic status was determined by fasting plasma glucose is >126mg/dl, 2- hour plasma glucose is >140mg/dl. Decayed, missing, and filled teeth indices were determined by means of clinical examination. Stimulated saliva with parafin was measured for flow rate and buffer capacity, level of S. mutans & Lactobacilli were analyzed with dentocult. There was no decrease in salivary secretion in patients with type 2 diabetes mellitus. Significant correlation were found between buffer capacity, and combination of the S. mutans & Lactobacilli counts in caries activity."

"Sepertiga masa kehidupan perempuan berlangsung dalam periode menopause, dengan lebih dari 80 % perempuan yang melaporkan gejala klimakterik dengan berbagai keluhan dan akibat pada tingkat kualitas kehidupan. Diabetes Melitus tipe 2 (DMT2) menyebabkan perubahan metabolik yang dapat menyebabkan menopause dini dan memperburuk gejala klimakterik. Penelitian kami bertujuan untuk mengetahui apakah terdapat hubungan antara gangguan tingkat kualitas hidup perempuan menopause yang mengalami DMT2, dengan durasi telah menopause, durasi telah DMT2, nilai antropometri, dislipidemia, tingkat aktivitas fisik, status nutrisi dan status kendali kadar glukosa darah. Studi potong lintang ini dilakukan pada bulan Januari hingga Februari 2024 pada 108 perempuan menopause dengan DMT2, yang merupakan peserta Program Pengelolaan Penyakit Kronis pada 15 Pusat Kesehatan Masyarakat tingkat Kecamatan, yang termasuk dalam kriteria penerimaan. Kuesioner The Menopause-spesific Quality Of Life (MENQOL) digunakan untuk mengetahui gejala klimakterik dan tingkat kualitas hidup. Studi ini menunjukkan bahwa gejala klimakterik dengan gangguan kualitas hidup tersering adalah nyeri sendi dan otot (72,2%), mudah pelupa (68,5%) dan kekuatan fisik berkurang (62,0%). Rerata tertinggi skor MENQOL untuk tiap aspek adalah aspek fisik (3,01 ± 1,06), diikuti oleh aspek psikososial (2,60 ± 1,24). Terdapat hubungan yang berbeda secara statistik pada faktor Indeks Massa Tubuh dengan gangguan aspek psikososial (p = 0,036) dan vasomotor (p = 0,005), lingkar pinggang dengan gangguan aspek vasomotor (p = 0,009), serta durasi telah DMT2 dengan gangguan aspek seksual (p = 0,032). Hasil penelitian ini menunjukkan bahwa terdapat dampak gejala klimakterik pada tingkat kualitas hidup perempuan menopause dengan DMT2, yang menekankan perlunya menciptakan kesadaran mengenai gejala klimakterik dan tata kelola untuk memperbaiki kualitas hidupnya.

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Background: One-third of a woman's lifespan occurs during the menopausal period, with over 80% of women reporting climacteric symptoms during menopause, resulting in various symptoms and consequences on the quality of life. Type 2 Diabetes Mellitus (T2DM) induces metabolic changes that can lead to early menopause and exacerbate climacteric symptoms. Our study aimed to investigate whether there is a relationship between disturbances in the quality of life of menopausal women with T2DM and the duration of menopause, duration of T2DM, anthropometric values, dyslipidemia, level of physical activity, nutritional status, and blood glucose control status.

Methods: A cross-sectional study was conducted from January to February 2024 involving 108 menopausal women with diabetes mellitus, who were participants of the Chronic Disease Management Program at 15 District Health Community Centers, meeting the inclusion criteria. The Menopause-Specific Quality Of Life (MENQOL) questionnaire was utilized to assess climacteric symptoms and the quality of life.

Results: This study revealed that the most prevalent climacteric symptoms affecting quality of life were joint and muscle pain (72.2%), poor memory (68.5%), and reduced physical strength (62.0%). The highest mean MENQOL scores for each aspect were in the physical domain (3.01 ± 1.06), followed by the psychosocial domain (2.60 ± 1.24). Furthermore, the Body Mass Index was found to significantly increase the quality of life disturbances in the psychosocial aspect (p = 0.036) and vasomotor (p = 0.005) aspects, waist circumference in the vasomotor aspect (p = 0.009), and duration of T2DM in the sexual aspect (p = 0.032).

Conclusion: Climacteric symptoms have an impact on the quality of life of menopausal women with T2DM, emphasizing the need to raise awareness about climacteric symptoms and the management to improve their quality of life."

"Penderita Diabetes Melitus (DM) Tipe 2 mengalami peningkatan risiko kanker yang diduga diakibatkan oleh kondisi hiperglikemia, hiperinsulinemia, dan inflamasi. Ketiga faktor tersebut dapat menginduksi proses tumorigenesis melalui jalur glukotoksisitas, lipotoksisitas, dan stres oksidatif. Penelitian ini bertujuan untuk mengukur dan membandingkan mutan p53 sebagai tumor marker pada pasien DM tipe 2 dan pasien DM tipe 2 yang menderita kanker, mengukur dan membandingkan HbA1c pada kedua kelompok, serta melihat korelasi mutan p53 dengan HbA1c pada kedua kelompok. Desain studi yang digunakan adalah cross-sectional dengan teknik pengambilan sampel consecutive sampling. Kelompok yang diteliti pada penelitian ini adalah pasien DM tipe 2 (n = 51) dan pasien DM tipe 2 yang menderita kanker (n = 51). Analisis mutan p53 pada serum sampel dilakukan menggunakan ELISA, sedangkan pengukuran HbA1c dilakukan dengan Afinion Analyzer. Pada penelitian ini kadar serum mutan p53 pada kelompok pasien DM tipe 2 (1,62 ± 0,08 ng/ml) tidak berbeda bermakna dengan kelompok pasien DM tipe 2 yang menderita kanker (1,64 ± 0,09 ng/ml) (p = 0,774). Sementara itu, HbA1c pada kelompok DM tipe 2 (8,42 ± 0,25 %) berbeda bermakna dengan kelompok DM tipe 2 yang menderita kanker (7,02 ± 0,20 %) (p < 0,001). Tidak terdapat hubungan yang bermakna antara kadar mutan p53 dengan HbA1c, baik pada kelompok DM tipe 2 (r = 0,083; p = 0,561), maupun kelompok DM tipe 2 yang menderita kanker (r = 0,072; p = 0,617). Penelitian ini menunjukkan bahwa kadar mutan p53 pada kelompok DM tipe 2 dan DM tipe 2 yang menderita kanker tidak berbeda bermakna, namun HbA1c pada kedua kelompok berbeda bermakna. Sementara itu, tidak terdapat hubungan yang bermakna antara kadar mutan p53 dengan HbA1c pada kedua kelompok.

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Type 2 Diabetes Mellitus has been found to increase the risk of cancer which is caused by conditions of hyperglycemia, hyperinsulinemia, and inflammation. These three factors are able to induce tumorigenesis through mechanisms of glucotoxicity, lipotoxicity, and oxidative stress. This study aimed to measure and compare mutant p53 as tumor marker in Type 2 Diabetes Mellitus patients and Type 2 Diabetes Mellitus patients with cancer, to measure and compare HbA1c level in both groups, and to analyze the correlation between mutant p53 and HbA1c level in both groups. This study was a cross-sectional study with consecutive sampling technique in which two groups were involved, namely type 2 diabetes mellitus patients (n = 51) and type 2 diabetes mellitus patients with cancer (n = 51). Serological level of mutant p53 protein was analyzed using ELISA and HbA1c was measured with HbA1c Afinion Analyzer.

The serological level of mutant p53 in the type 2 diabetes mellitus patients (1.62 ± 0.08 ng/ml) showed no significant difference compared with type 2 diabetes mellitus patients with cancer (1.64 ± 0.09 ng/ml) (p = 0.774). Meanwhile, HbA1c level showed significant difference between type 2 diabetes mellitus patients (8.42 ± 0.25 %) and type 2 diabetes mellitus patients with cancer (7.02 ± 0.20 %) (p < 0.001). Mild correlations between mutant p53 and HbA1c level were found in both type 2 diabetes mellitus patients (r = 0.083; p = 0.561) and type 2 diabetes mellitus patients with cancer (r = 0.072; p = 0.617). Based on the result, there was no significant difference between mutant p53 in type 2 diabetes mellitus patients with and without cancer. HbA1c level was found to be significantly different in both groups. Meanwhile, there was no significant correlation between mutant p53 and HbA1c in both groups."

"Glikosaminoglikan merupakan komponen penyusun glikokaliks yang berperan penting dalam per selektivitas muatan anionik kapiler glomerulus. Gangguan hemodinamik dan metabolik akibat hiperglikemia kronis menyebabkan peluruhan komponen glikokaliks endotel. Beberapa pedoman telah menyetujui keamanan tiap OAD berdasarkan fungsi ginjal. Tujuan penelitian adalah menilai keamanan penggunaan metformin (metformin dan metformin-glimepirid) berdasarkan fungsi ginjalnya serta menilai perbandingan kadar GAG urin pasien DMT 2 kelompok risiko rendah terhadap risiko sedang-tinggi PGK. Desain penelitian potong lintang dan metode consecutive di Puskesmas Depok Jaya dan Kecamatan Pasar Minggu. Sampel urin dan darah dikumpulkan untuk pengukuran eLFG, HbA1c, ACR, dan kadar GAG urin. Sebanyak 137 partisipan dinilai keamanan penggunaan metformin berdasarkan fungsi ginjalnya. Terdapat ketidaksesuaian pada 1 partisipan dalam penggunaan metformin (n=55) dan semua partisipan (n=82) sesuai dengan pedoman dalam penggunaan metformin-glimepirid. Hanya 121 partisipan yang dianalisis kadar GAG urin menggunakan 1,9-DMMB dan terdiri dari 4 yaitu kelompok risiko rendah PGK: G1-A1(eLFG ≥90ml/min/1,73m² - <30mg/g) (n=25) dan G2-A1(eLFG 60-89ml/min/1,73m² - <30mg/g) (n=45) serta risiko sedang-tinggi PGK: GI-A2(eLFG ≥ 90ml/menit/1,73m² - >30mg/g) (n=23) dan G2-A2(eLFG 60-89ml/menit/1,73m² - >30mg/g) (n=28). Tidak ada perbedaan bermakna (p<0,05) pada karakteristik dasar dan klinis keempat kelompok kecuali usia (p=0,006) dan HbA1c (p<0,001). Tidak terdapat perbedaan kadar GAG urin yang bermakna antara kelompok G1 dengan G2 (p=0,290) serta pada keempat kelompok (p=0,221). Terdapat perbedaan kadar GAG urin yang bermakna (p=0,034) pada kelompok normoalbuminuria dan albuminuria. Faktor lain seperti durasi DMT 2 >5 tahun dan komorbiditas dapat meningkatkan kadar GAG urin. Oleh karena itu, diperlukan studi lanjut mengenai potensi GAG urin pada awal perkembangan penyakit ginjal diabetes.

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Glycosaminoglycans are components of the glycocalyx which play an important role in the permeselectivity of the anionic charge of the glomerular capillaries. Hemodynamic and metabolic disturbances due to chronic hyperglycemia cause the breakdown of the glycocalyx component of the endothelium. Several guidelines have agreed on the safety of each OAD based on renal function. The aims of this study were to assess the safety of using metformin (metformin and metformin-glimepiride) based on kidney function and to evaluate the comparison of urinary GAG levels in patients with DMT 2 in low-risk groups to moderate-high risk of CKD. Cross-sectional research design and consecutive in Depok Jaya Public Health Center and Pasar Minggu District. Urine and blood samples were collected for measurement of eGFR, HbA1c, ACR, and urinary GAG levels. A total of 137 participants assessed the safety of using metformin based on their kidney function. There was a discrepancy in 1 participant in the use of metformin (n=55) and all participants (n=82) according to the guidelines for the use of metformin-glimepiride. Only 121 participants were analyzed for urine GAG ​​levels using 1,9-DMMB and consisted of 4 low risk groups for CKD: G1-A1(eGFR 90ml/min/1.73m² - <30mg/g) (n=25) and G2-A1(eGFR 60-89ml/min/1.73m² - <30mg/g) (n=45) and moderate-high risk of CKD: GI-A2(eGFR 90ml/min/1.73m² - >30mg/g) (n=23) and G2-A2(eLFG 60-89ml/min/1.73m² - >30mg/g) (n=28). There was no significant difference (p<0.05) in the baseline and clinical characteristics of the four groups except age (p=0.006) and HbA1c (p<0.001). There was no significant difference in urine GAG ​​levels between the groups G1 with G2 (p= 0.290) and in the four groups (p= 0.221). There was a significant difference in urine GAG ​​levels (p= 0.034) in the normoalbuminuria and albuminuria groups. Other factors such as duration of DMT 2 > 5 years and comorbidities can increase urinary GAG levels. Therefore, further studies are needed regarding the potential of urinary GAGs in the early development of diabetic kidney disease. "