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"Measurement of non-invasive blood glucose is one way to increase the frequency of self-monitoring of blood glucose(SMBG). For NIR reflectance spectroscopy, its application in non-invasive constrained by high value of standard errorof prediction. The mean standard error of prediction was 25 mg/dL. Theoretically, NIR reflectance spectroscopy stillcan be used to predict blood glucose levels in certain conditions such as hypoglycemia (<55 mg/dL), controlled fastingblood glucose (FBG) (70-115 mg/dL), and hyperglycemia (>225 mg/dL), which the difference between the threeconditions is more than 25 mg/dL. The results showed that there were significant differences in standards values ofphotometer measurement between controlled FBG and hyperglycemic conditions (p = 0.002). The results also showedthat the photometer can be used to assist the monitoring of blood glucose in FBG under control and hyperglycemicconditions. It can be seen from the average percentage of the daily controlled FBG conditionsin patients conductingSMBG in photometer-assisted compared to in patientsonly use SMBG once a day (28% versus 18%, p = 0.344).Fotometer Sederhana sebagai Alat Bantu Pengukuran Glukosa Darah. Pengukuran glukosa darah secara noninvasifmerupakan salah satu cara untuk meningkatkan frekuensi pemantauan glukosa darah mandiri (PGDM). Untukyang berbasis spektoskopi reflektansi NIR, penerapannya secara non-invasif terkendala nilai standar error of predictionyang tinggi. Namun demikian metode ini secara teori masih dapat dipakai untuk memprediksi kadar glukosa darah padakondisi tertentu seperti keadaan hipoglikemia (<55 mg/dL), gula darah puasa (GDP) terkendali (70-115 mg/dL), danhiperglikemia (>225 mg/dL). Hasil penelitian menunjukkan bahwa terdapat perbedaan bermakna standar nilaipengukuran fotometer antara kondisi GDP terkendali dan hiperglikemia (p = 0,002). Fotometer yang digunakan dapatmembantu pemantauan glukosa darah (PGDM pada kondisi GDP terkendali dan hiperglikemia). Hal ini dapat dilihatdari rata-rata persentase jumlah hari dengan kondisi GDP harian terkendali yang lebih besar pada PGDM yang dibantudengan fotometer dibandingkan PDGM yang dilakukan hanya satu kali sehari (28% berbanding 18%, p = 0,344)."

"Hiperglikemia merupakan kondisi medis dimana kadar glukosa darah melebihi normal dan menjadi karakteristik beberapa penyakit terutama diabetes melitus. Indonesia sendiri menempati posisi ke-5 dengan penderita diabetes terbanyak di dunia dengan jumlah 19,5 juta jiwa. Kondisi diabetes melitus sering dikaitkan dengan pola makan seseorang. Penelitian menyatakan bahwa restriksi kalori dapat memberikan efek samping lebih minim dibandingkan dengan obat-obatan. Salah satu metode restriksi kalori yang memiliki efek antihiperglikemik adalah Fasting-Mimicking Diet (FMD). Tujuan dari penelitian ini adalah untuk mengetahui efek perlakuan FMD terhadap penurunan kadar glukosa darah, peningkatan kolesterol, dan sensitivitas insulin sebagai gejala awal diabetes melitus. Penelitian ini dilakukan menggunakan control group design dengan jumlah 16 ekor tikus, dengan 4 kelompok perlakuan (normal diet, hiperglikemia, FMD, dan metformin). Tikus-tikus diberikan pakan tinggi lemak selama 28 hari sebelum diinduksi streptozotocin (STZ). Perlakuan FMD dilakukan selama 28 hari sebelum akhirnya tikus dikorbankan untuk diambil darahnya. Oral glucose tolerance test (OGTT) dilakukan pada tikus yang telah dipuasakan selama 18 jam lalu diadministrasikan dengan glukosa (2gr/kgBB). Analisis peningkatan glukosa darah dilakukan pada menit ke-0, 15, 30, 60, dan 120. Tikus selanjutnya dikorbankan untuk diambil darahnya dan dilakukan uji menggunakan program SPSS versi 25 dan GraphPad versi 9.4.0 untuk MacOS. Hasilnya, terdapat penurunan kadar glukosa darah pada kelompok metformin dan FMD. Penelitian ini menyimpulkan bahwa FMD dapat menurunkan kadar glukosa darah pada tikus hiperglikemia dan FMD tidak memberikan perbedaan signifikan terhadap terapi oral metfomin.

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Hyperglycemia is a medical condition in which the blood glucose levels are higher than normal, and is a characteristic of several diseases, particularly diabetes. Indonesia ranks 5th in the number of diabetic patients in the world, with the number of approximately 19.5 million people. Diabetes is frequently associated with dietary habits, and research shows that calorie restriction can give fewer side effects compared to medications. One of the calorie restriction methods that have anti-hyperglycemic effects is Fasting-Mimicking Diet (FMD). The aim of this study is to determine the effect of Fasting-Mimicking Diet on lowering blood glucose level, increasing cholesterol levels, and insulin sensitivity as an early sign of diabetes mellitus. This study was conducted using a control group design with a total of 16 mice grouped into 4 treatments (normal diet, hyperglycemia, FMD, and metformin). The mice were given one week acclimation period and fed a high-fat diet (HFD) for 28 days before injected with streptozotocin (STZ). The treatment of FMD was carried out for another 28 days before the mice is sacrificed for blood collection. Oral glucose tolerance test was performed a week after the treatmet of FMD, following 18 hours of fasting and administration of glucose (2 g/kg). The increase of blood glucose levels were monitored at 0, 15, 30, 60, and 120 minutes. The mice is then sacrificed for blood collection and analysis was done using SPSS Statistics version 25.0 and GraphPad version 9.4.0 for MacOS. The result of FMD given was decreased of glucose level on FMD and metformin groups. This study concludes that FMD can significantly decrease blood glucose level in hyperglycemic rats and did not provide a significant difference to oral metformin therapy."

"ABSTRAKLatar Belakang. Hiperglikemia yang terjadi selama masa perawatan di rumah sakit pada pasien dengan penyakit kritis telah diketahui akan memberikan luaran klinis yang buruk bahkan dapat berujung pada kematian. Hiperglikemia yang terjadi pada pasien sindrom koroner akut (SKA) akan berakibat pada gangguan regenerasi sel endotel dan pembentukan pembuluh darah kolateral (revaskularisasi). Sayangnya, manajemen hiperglikemia sampai saat ini masih belum dicapai kata sepakat terutama perbedaan dalam menentuksn nilai potong dalam evaluasi glukosa lanjutan.Tujuan. Untuk mengetahui pengaruh hiperglikemia selama perawatan terhadap kesintasan(mortalitas) enam bulan pasien SKA dan mencari nilai potong ideal jntuk evaluasi lanjutan dan target kendali selama perawatanMetodologi. Penelitian dilakukan secara kohort retrospestif pada pasien SKA di dirawat di instalasi ICCU RSUPN Cipto Mangunkusumo Jakarta, dengan melibatkan pasien yang dirawat sampai dengan Desember 2011. Pengambilan data subjek penelitian dilakukan melalui data sekunder dengan pendaraan rekam medis dan dilakukan secara konsekutif.Hasil. Kami mendapatkan 807 pasien SKA selama periode Januari tahun 2000 sampai dengan Desember tahun 2011 yang memenuhi kriteria inklusi dan ekslusi. Hiperglikemia selama perawatan terjadi 242 (30 %) subjek penelitian. Hiperglikemia yang memberikan pengaruh pada kesintasan enam bulan dengan meningkatkan resiko kematian (HR 2,16 dengan IK 95% 1,77 sampai 2,63). Nilai potong glukosa darah yang memberikan kemaknaan pada kesintasan berada pada nilai 142,5 mg/dL.Kesimpulan. Pasien dengan hiperglikemia memiliki kesintasan yang lebih buruk dibandingkan pasien tanpa hiperglikemia. Nilai glukosa darah 142,5 mg/dL dapat dipergunakan sebagai nilai potong untuk evaluasi glukosa darah lanjutan selama masa perawatan.

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ABSTRACTBackground. Hyperglicemia during hospitalization especially on critically ill patients has worse clinical outcome and deadly. Patient with hyperglicemiain in acute coronary syndrome (ACS) will hamper endotelial regeneration and revascularization of coronary blood vessels. Unforrtunately, up until now rate of blood glucose cut off in hyperglycemia management had not reached any consession although we undoubtfully agree that this concept is very important in evaluation and choosing goal treatment.Aim. To determine the impact of hyperglicemia during admission in six month mortality rate of ACS patients and the best blood glucose cut off for evaluation and goal treatment.Method. This research used retrospective cohort on ACS patients admitted in ICCU, Cipto Mangukusumo Hospital, Jakarta, untill December 2011. Subjects' data were collected through medical records consecutively.Results. This research found that there were 807 ACS patients admitted during Januari 2000 to December 2011 that met inclusion and exclusion criterias. Hyperglicemia during admission was found on 242 (30 %) subjects. This condition statistically proven to increase six month mortality rate (HR 2, 16 with CI 95% 1,77 till 2,63). The best rate of Blood Glucose cut of for evaluation and management was 142,5mg/dL.Conclussion. There was significant difference mortality rate between hyperglicemia patients and non hyperglicemia.Blood glucose level on 142, 5 mg/dL could be used as cut off evaluation during admission."

"Latar belakang: Skor MSOFA telah dikembangkan sebagai critical care triage pada rumah sakit dengan sumber daya terbatas. Di Indonesia telah diteliti performa MSOFA sebagai prediktor mortalitas terhadap pasien penyakit kritis namun terbatas pada pasien bedah. Hasil evaluasi prediksi mortalitas MSOFA menunjukkan kemampuan prediksi mortalitas yang cenderung rendah. Penambahan variabel lain pada skor MSOFA untuk meningkatkan prediksi mortalitas perlu diteliti lebih lanjut. Hiperglikemia pada penyakit kritis tanpa riwayat diabetes melitus (hiperglikemia akibat stres) berdasarkan penelitian merupakan faktor risiko independen terhadap mortalitas.Tujuan: Melakukan validasi MSOFA serta nilai tambah kadar glukosa darah sebagai prediktor mortalitas pasien penyakit kritis tanpa riwayat diabetes melitus.Metode penelitian: Penelitian prospektif kohort pada pasien penyakit kritis medis maupun bedah di RSUPN Cipto Mangunkusumo selama periode Agustus hingga Desember 2013. Pasien dilakukan anamnesis, pemeriksaan fisik, saturasi oksigen perifer, glasgow coma scale, pemeriksaan laboratorium kadar kreatinin, pemeriksaan glukosa darah sewaktu serta A1C dalam 24 jam pertama perawatan. Outcome penelitian ini adalah mortalitas dalam 28 hari. Analisis statistik menggunakan tes Hosmer-Lemeshow, plot kalibrasi serta kurva ROC.Hasil: Subjek penelitian sebanyak 150 pasien. Mortalitas terjadi pada 52 pasien (34,67%) dengan sepsis sebagai masalah terbanyak. Kalibrasi MSOFA menunjukkan Hosmer-Lemeshow x2=13,748(p=0,056). Diskriminasi MSOFA menunjukkan AUC 0,83 (IK 95% 0,76-0,89). Hiperglikemia terjadi pada 79 pasien (52,67%). Penambahan kadar glukosa darah pada MSOFA tidak menunjukkan peningkatan AUC.Simpulan: Validasi MSOFA menunjukkan kalibrasi dan diskriminasi yang baik pada pasien penyakit kritis baik medis maupun bedah. Penambahan kadar glukosa darah pada skor MSOFA tidak meningkatkan kemampuan prediksi mortalitas.

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Background: MSOFA, a simple scoring system, has been developed as a critical care triage in centers with limited resources. Previous study have evaluated MSOFA’s performance but limited only in surgical critically ill patients which showed a low precision in predicting mortality. Addition of another variable to improve MSOFA’s performance merits further investigation. Hyperglycemia in critically ill patients without previous history of diabetes (stress hyperglycemia) has been shown to be an independent risk factor of mortality.

Objective: to evaluate MSOFA scoring system’s performance and addition of admission blood glucose test to predict mortality in critically ill patient without previous history of diabetes.

Methods: This was a prospective cohort study recruiting medical and surgical critically ill patients admitted to Cipto Mangunkusomo Hospital during a period of August to December 2013. History taking, physical examination, peripheral oxygen saturation, Glasgow Coma Scale, creatinine, blood glucose and A1C were obtained within 24 hour of admission. The outcome was mortality within 28 days. Performance of MSOFA was evaluated with the Hosmer-Lemeshow goodness of fit test and measuring the AUC.

Results: 150 patients completed the study protocols. Mortality was observed in 52 patients (34,67%) with sepsis being the most prevalent diagnosis. Calibration of MSOFA showed a Hosmer-Lemeshow test x2=13.748 (p = 0.056). Receiver Operating Curve (ROC) of MSOFA showed an AUC of 0,83 (95% CI 0,76-0,89). Stress hyperglycemia was evident in 79 patients (52,67%) recruited in this study. Addition of blood glucose to MSOFA scoring system did not show improvement in MSOFA’s performance.

Conclusion: We have validated MSOFA in this study which showed good calibration and discrimination in both medical and surgical critically ill patients. Adding blood glucose to MSOFA scoring system did not improve MSOFA’s performance."

"Fotometer Sederhana sebagai Alat Bantu Pengukuran Glukosa Darah. Pengukuran glukosa darah secara non- invasif merupakan salah satu cara untuk meningkatkan frekuensi pemantauan glukosa darah mandiri (PGDM). Untuk yang berbasis spektoskopi reflektansi NIR, penerapannya secara non-invasif terkendala nilai standar error of prediction yang tinggi. Namun demikian metode ini secara teori masih dapat dipakai untuk memprediksi kadar glukosa darah pada kondisi tertentu seperti keadaan hipoglikemia (<55 mg/dL), gula darah puasa (GDP) terkendali (70-115 mg/dL), dan hiperglikemia (>225 mg/dL). membantu pemantauan glukosa darah (PGDM pada kondisi GDP terkendali dan hiperglikemia). Hal ini dapat dilihat dari rata-rata persentase jumlah hari dengan kondisi GDP harian terkendali yang lebih besar pada PGDM yang dibantu dengan fotometer dibandingkan PDGM yang dilakukan hanya satu kali sehari (28% berbanding 18%, p = 0,344).

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Measurement of non-invasive blood glucose is one way to increase the frequency of self-monitoring of blood glucose (SMBG). For NIR reflectance spectroscopy, its application in non-invasive constrained by high value of standard error of prediction. The mean standard error of prediction was 25 mg/dL. Theoretically, NIR reflectance spectroscopy still can be used to predict blood glucose levels in certain conditions such as hypoglycemia (<55 mg/dL), controlled fasting blood glucose (FBG) (70-115 mg/dL), and hyperglycemia (>225 mg/dL), which the difference between the three conditions is more than 25 mg/dL. The results showed that there were significant differences in standards values of photometer measurement between controlled FBG and hyperglycemic conditions (p = 0.002). The results also showed that the photometer can be used to assist the monitoring of blood glucose in FBG under control and hyperglycemic conditions. It can be seen from the average percentage of the daily controlled FBG conditionsin patients conducting SMBG in photometer-assisted compared to in patientsonly use SMBG once a day (28% versus 18%, p = 0.344)."

"Latar Belakang. Hiperglikemia pada perawatan pasien kritis merupakan faktor risiko yang dapat ditatalaksana dengan optimal untuk menurunkan mortalitas. Hubungan variabilitas glukosa dengan mortalitas telah diteliti menggunakan indikator yang bervariasi. Tujuan. Mengkaji hubungan variabilitas glukosa yaitu rerata perubahan glukosa absolut (mean absolute glucose change, MAG) dan simpang baku glukosa terhadap mortalitas pasien kritis. Metode. Penelitian kohort retrospektif terhadap 280 pasien yang dirawat di Unit Perawatan Intensif RSCM pada periode Januari 2012-Agustus 2013. Variabel MAG dan simpang baku glukosa dibagi menjadi 4 kuartil. Analisis hubungan antara MAG dan simpang baku glukosa dengan mortalitas dilakukan dengan uji X2. Untuk mengeluarkan faktor perancu (skor MSOFA, indeks komorbiditas Charlson, hipoglikemia, dan hiperglikemia) dilakukan uji regresi logistik. Hasil. Nilai median MAG adalah 3,3 mg/dL/jam dan nilai median simpang baku glukosa adalah 38,3 mg/dL Insiden mortalitas lebih tinggi didapatkan pada kuartil atas MAG dan simpang baku glukosa dibandingkan kuartil bawah. Dari uji Chi Square didapatkan hasil OR MAG kuartil atas terhadap mortalitas OR 4,26 (IK 95% 1,98-9,15) dan OR simpang baku glukosa kuartil atas terhadap mortalitas OR 2,78 (IK 95% 1,35-5,71). Setelah dilakukan uji regresi logistik didapatkan fully adjusted OR 3,34 (IK 95% 1,08-10,31) untuk MAG dan 0,90 (IK 95% 0,28-2,88) untuk simpang baku glukosa. Simpulan. Insiden mortalitas pasien dengan MAG tinggi lebih besar daripada pasien dengan MAG paling rendah. Proporsi mortalitas simpang baku glukosa tinggi (>59 mg/dL) lebih besar daripada pasien dengan simpang baku glukosa paling rendah, namun perbedaan tersebut tidak bermakna secara statistik.

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Background. Hyperglycemia in critically-ill patient is a risk factor that can be managed in order to reduce mortality. Inspite of hyperglycemia, glucose variability also brings negative outcome to cells. Studies about glucose variability effect to mortality had been studied using many variables of glucose variability.

Objective. Analyze association between glucose variability (mean absolute glucose change [MAG] and glucose standard deviation) with mortality in critically-ill patients.

Methods. Retrospective cohort study is done to 280 critical ill patient in ICU and HCU in Cipto Mangunkusumo Hospital who admitted to critical care between January 2012-August 2013. MAG change and glucose standard deviation are divided into 4 quartiles. Association between MAG change and glucose standard deviation are analyzed using X2 test. To control the confounders (MSOFA score, Charlson comorbidities index, hypoglycemia, and hyperglycemia), logistic regression is done.

Result. Median of MAG change is 3.3 mg/dL/hour and median of glucose standard deviation is 37.63 mg/dL. Mortality incidence is higher in upper quartile of MAG change and glucose standard deviation compared to lower quartile. OR of upper quartile MAG change to ICU mortality is OR 4.26 (95% CI 1.98-9.15) and OR of upper quartile glucose standard deviation to ICU mortality is OR 2.78 (95% CI 1.35-5.71). These results are adjusted to MSOFA score, hypoglycemia, and hyperglycemia. In logistic regression test, fully adjusted OR are 3.34 (95% CI 1.08-10.31) and 0.90 (95% CI 0.28-2.88) for MAG change and glucose standard deviation, respectively.

Conclusion. Mortality incidence in patient with high MAG is larger than in patient with lowest MAG change. Mortality incidence in patient with high glucose standard deviation is larger than in patient with lowest glucose standard deviation, but the difference is not statistically significant."

"Typical clinical symptoms and chest X-ray is a marker of Tuberculosis (TB) sufferers. However, the diagnosis of TB in adults should be supported by microscopic examination. Currently, Bacilli microscopic examination of acid-fast bacilli (AFB) in sputum by Ziehl-Neelsen (ZN) coloring is the most widely used. However, for reasons of convenience,especially for laboratories with a considerable amount of smear samples, and due to higher sensitivity compared with ZN staining, the World Health Organization (WHO) has recommended the use of auramine-O-staining (fluorochrome staining), which is visualized by light emitting diode (LED) fluorescence microscopy. The aim of this study was to evaluate the performance of modified light microscope with homemade LED additional attachment for examination ofAFB in sputum using auramine-O-staining method. We compared the sensitivity and specificity of 2 kinds of AFB in sputum methods: ZN and fluorochrome, using culture on Lowenstein-Jensen media as the gold standard. The results showed auramine-O-staining gives more proportion of positive findings (81%) compared to the ZN method (70%). These results demonstrated that the sensitivity of auramine-O-staining was higher than ZN, however it gives more potential false positive results than ZN. The sensitivity of auramine-O-staining in detecting AFB in sputum was 100% while the specificity was 88%."

"Latar belakang. Pemberian cairan intravena pada pasien anak yang menjalani tindakan bedah berfungsi untuk mempertahankan keseimbangan metabolik tubuh. Pemilihan cairan perioperatif yang tidak tepat dapat menimbulkan komplikasi berupa asidosis metabolik, hiponatremia, hipoglikemi, atau hiperglikemia.Tujuan. Mengetahui profil pemberian cairan perioperatif di Rumah Sakit Cipto Mangunkusumo (RSCM) serta pengaruhnya terhadap keseimbangan asam basa serta kadar elektrolit dan gula darah serum. Metode. Studi deskriptif kohort prospektif pada pasien anak (1 bulan ? 18 tahun) yang menjalani tindakan bedah elektif di RSCM. Jenis dan jumlah cairan perioperatif yang diberikan dicatat, serta dilakukan pemeriksaan laboratorium (analisis gas darah, elektrolit dan gula darah serum) sesaat sebelum tindakan bedah, setelah tindakan bedah, serta 6 jam setelah pemberian cairan postoperatif.Hasil penelitian. Dari 61 subyek yang diteliti, 65,6% tidak mendapat cairan preoperatif. Cairan yang paling banyak digunakan sebagai cairan intraoperatif adalah Ringer asetat malat (RAM) yaitu 77% dan cairan postoperatif adalah kristaloid hipotonik (83,6%). Jumlah cairan preoperatif dan postoperatif sebagian besar sesuai formula Holliday-Segar. Subyek yang mendapat cairan preoperatif D10 1/5 NS + KCl (10) lebih banyak mengalami hiponatremia (13,4% vs 5%) dan gangguan kadar gula darah (20% vs 0%) dibandingkan dengan subyek yang tidak mendapat cairan. Asidosis metabolik terjadi pada kelompok cairan intraoperatif RAM (36,2%) maupun Ringer asetat (36,4%). Hiponatremia pasca pemberian cairan postoperatif terjadi pada 57,1% subyek yang tidak mendapat cairan, 44,4% pada kelompok KA-EN3B®, dan 21,9% pada kelompok D10 1/5 NS + KCl (10). Hiperglikemia terjadi pada 15,6% subyek yang mendapat D10 1/5 NS + KCl (10).Simpulan. Pemberian cairan perioperatif di RSCM bervariasi. Angka kejadian hiponatremia pasca pemberian kristaloid hipotonik adalah 13,4 - 44,4%. Hiponatremia dan gangguan kadar gula darah terjadi pada subyek yang mendapat cairan D10 1/5 NS + KCl (10).

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Background. Intravenous fluid in pediatric surgery patients aimed to maintain acid-base balance and also normal serum electrolyte and blood glucose. Inappropriate perioperative fluid management may cause complications such as metabolic acidosis, hyponatremia, hypoglycemia, or hyperglycemia.Objects. To study the profile of perioperative fluid for pediatric patients in Cipto Mangunkusumo Hospital (CMH) and its effects on acid-base balance, electrolyte, and blood glucose. Method. A descriptive prospective cohort study in children aged 1 month to 18 years old who underwent elective surgery in CMH. The intravenous perioperative fluid given to the patients and their amount were recorded. Laboratory examinations were done 3 times (right before surgery, right after surgery, and 6 hours after postoperative fluid was started), which are blood gas analysis, serum electrolyte, and blood glucose.Results. Among 61 subjects, 65,6% did not receive any preoperative fluid. The most common intravenous fluid were Ringer?s acetate malate (RAM) which is 77% as intraoperative fluid and hypotonic crystalloids (83,6%) as postoperative fluid. The amount of preoperative and postoperative fluid was mostly in accordance with Holliday-Segar formula. Subjects who had D10 1/5 NS + KCl (10) as preoperative fluid had more hyponatremia (13,4% vs 5%) and blood glucose disturbance (20% vs 0%) compared to subjects without preoperative fluid. Metabolic acidosis occurred in subjects who had either RAM (36,2%) or Ringer?s acetate (36,4%) as intraoperative fluid. Hyponatremia 6-hours after postoperative fluid occurred in 57,1% subjects without intravenous fluid, 44,4% subjects who had KA- EN3B®, and 21,9% subjects who had D10 1/5 NS + KCl (10). Hyperglycemia occurred in 15,6% subjects who had D10 1/5 NS + KCl (10).Conclusion. There is a variety in perioperative fluid in CMH. Hyponatremia incidence after receiving hypotonic crystalloid is 13,4 - 44,4%. Hyponatremia and blood glucose disturbances occured in subjects who had D10 1/5 NS + KCl (10)."

"Diabetes melitus merupakan penyakit kronik yang dapat menimbulkan stress. Relaksasi dengan terapi murotal Al-Qur’an merupakan terapi yang dapat mengatasi hiperglikemia. Penelitian ini bertujuan untuk membuktikan pengaruh terapi murotal Al-Qur’an terhadap kadar glukosa darah pada DM tipe 2. Desain penelitian ini adalah quasi eksperimen pre-post with control group. Jumlah sampel 39 orang dibagi dalam dua kelompok yaitu 20 orang dalam kelompok intervensi dan 19 orang pada kelompok kontrol, pemilihan responden purposive sampling. Uji statistik yang digunakan uji Anova repeated measure. Hasil penelitian didapatkan ada pengaruh terapi murotal Al-Qur’an terhadap penurunan kadar glukosa darah sebesar 61 mg/dl (p=0,029, ). Kesimpulan penelitian ini, terapi murotal Al-Qur’an efektif menurukan kadar glukosa darah pada pasien diabetes melitus tipe 2.

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Diabetes mellitus is a chronic disease that can cause stress. Murotal Qur'an relaxation therapy is a therapy that suggested to reduce hyperglycemia. This study aimed to examine the effect of murotal Qur'an therapy on blood glucose levels. This study design was quasi-experimental pre-post with control group. Number of samples are 39 people who were divided into two groups: the intervention group consist of 20 people, and 19 people in the control group, the selection of participants with purposive sampling. Statistical tests were using repeated measure Anova test. The results of this study found there was an effect of murotal Qur'an therapy to decrease blood glucose levels (p = 0.029, ? = 0.05). In conclusion, murotal Qur'an therapy effectively to decrease blood glucose levels in patients with type 2 diabetes mellitus"

"Hiperglikemia merupakan salah satu faktor risiko terjadinya nefropati diabetik pada pasien diabetes melitus tipe 2. American Diabetes Association (ADA) merekomendasikan pemeriksaan albumin-to-creatinine ratio (ACR) setiap tahun untuk mendeteksi adanya nefropati diabetik. Pemeriksaan 1,5-anhydroglucitol (1,5-AG) merupakan salah satu pemeriksaan untuk monitoring kontrol glikemik. 1,5-AG merupakan penanda yang lebih sensitif untuk mengetahui adanya fluktuasi glukosa dan hiperglikemia postprandial. Beberapa penelitian menunjukkan bahwa hiperglikemia yang terjadi secara intermiten lebih merusak endotel dibandingkan hiperglikemia yang stabil. Desain studi pada penelitian ini adalah potong lintang. Pada penelitian ini dilakukan analisis statistik untuk mendapatkan hubungan 1,5-AG dan HbA1c, 1,5-AG dan glukosa darah 2 jam PP, area under curve dan titik potong 1,5-AG sebagai indikator kontrol glikemik, dan perbedaan median kadar 1,5-AG serta HbA1c pada pasien dengan ACR < 30 mg/g dan ≥ 30 mg/g. Hasil penelitian ini didapatkan koefisien korelasi Spearman antara kadar 1,5-AG dan HbA1c pada pasien DMT2 adalah -0,74 (p<0,001), sedangkan nilai koefisien korelasi antara kadar 1,5-AG dan glukosa darah 2 jam PP pada pasien diabetes melitus tipe adalah -0,45 (p<0,001). Luas area under curve 1,5-AG sebagai indikator kontrol glikemik sebesar 87,1%. Titik potong 1,5-AG untuk indikator kontrol glikemik adalah 10,7 μg/mL. Pasien DMT2 dengan kadar ACR ≥ 30 mg/g memiliki median kadar 1,5-AG yang lebih rendah (6,4 μg/mL) dibandingkan pasien DMT2 dengan ACR < 30 mg/g (median kadar 1,5-AG 12,4 μg/mL), p = 0,007. Terdapat perbedaan median kadar HbA1c yang bermakna (p<0,001) pada pasien DMT2 dengan ACR < 30 mg/g dan ACR ≥ 30 mg/g. Pasien DMT2 dengan kadar ACR ≥ 30 mg/g memiliki median kadar HbA1c yang lebih tinggi (7,9%) dibandingkan kadar HbA1c pasien DMT2 dengan ACR < 30 mg/g (6,9%). Berdasarkan hasil penelitian ini, dapat disimpulkan terdapat korelasi negatif kuat bermakna antara 1,5-AG dan HbA1c; dan korelasi negatif sedang bermakna antara 1,5-AG dan glukosa darah 2 jam PP. Terdapat perbedaan rerata kadar 1,5-AG dan HbA1c yang bermakna antara pasien diabetes melitus dengan ACR < 30 mg/g dan ≥ 30 mg/g. Titik potong 1,5-AG yang direkomendasikan sebagai indikator kontrol glikemik adalah 10,7 μg/mL.

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Hyperglycemia is one of the risk factors for diabetic nephropathy in type 2 diabetes mellitus patients. American Diabetes Association (ADA) recommended annual albumin-tocreatinine ratio (ACR) screening to detect the presence of diabetic nephropathy. 1,5-anhydroglucitol (1,5-AG) is one of the parameters for monitoring glycemic control. 1,5-AG is a more sensitive marker to detect glucose fluctuations and postprandial hyperglycemia. Previous studies showed that intermittent hyperglycemia is more damaging to endothelials than stable hyperglycemia. The study design was cross sectional. In this study, the statistical analysis was performed to obtain the association between 1,5-AG and HbA1c, 1,5-AG and 2-hour postprandial blood glucose; the area under curve and the cutoff of 1,5-AG as an indicator of glycemic control; and the median difference of 1,5-AG and HbA1c value from patients with ACR <30 mg/g and ≥ 30 mg/g. In this study, the coefficient of correlation between the value of 1,5-AG and HbA1c in patients with T2DM is -0,74 (p<0,001), while the coefficient of correlation between 1,5-AG and 2-hour postprandial blood glucose in patients with diabetes mellitus type is -0,45 (p<0,001). The area under curve of 1,5-AG as a glycemic control indicator is 87,1%. The 1,5-AG cutoff point for the glycemic control indicator is 10,7 μg/mL. Patients with T2DM with ACR levels ≥30 mg/g had significantly lower median value of 1,5-AG (6,4 μg/mL) than patients with T2DM with ACR <30 mg/g (12,4 μg/mL). There was significant difference in median HbA1c value from patients with T2DM with ACR <30 mg/g and ≥ 30 mg/g. Patients with T2DM with ACR levels ≥30 mg/g had higher median HbA1c value (7,9%) than HbA1c patients with T2DM with ACR <30 mg/g (6,9%). In this study concluded that the there was a strong and significant negative correlation between 1.5-AG and HbA1c and a moderate and significant negative correlation between 1.5-AG and 2-hour postprandial blood glucose. There was a significant difference of median value of 1,5-AG and HbA1c between patients with diabetes mellitus and ACR <30 mg/g and ACR ≥ 30 mg/g. The cutoff of 1,5-AG which was recommended as a glycemic control indicator was 10,7 μg/mL."