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"Background: hypoglycemia is a major adverse event of insulin therapy for diabetes mellitus patients. The study was conducted to evaluate the incidence of hypoglycemia among insulin treated patients with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) in the Indonesian cohort. Methods: this Indonesian cohort study consisted of retrospective and prospective evaluation of hypoglycemic episodes, using International Operations Hypoglycemia Assessment Tool (IO HAT) in 374 patients with diabetes (T1DM; n=17 or T2DM; n=357). The patients of ≥18 years of age and treated with insulin for >12 months were selected for this study (ClinicalTrials.gov number: NCT02306681). Results: a total of 374 patients were enrolled in this study and completed SAQ1. All patients with T1DM (17 [100%]), and 347 (97.2%) patients with T2DM completed SAQ2. Almost all the patients in the 4-week prospective period reported at least one hypoglycemic event (T1DM 100%, T2DM 99.4%) and the incidence rate of any hypoglycemia was 67.5 events per patient-year (PPY) and 25.7 events PPY for T1DM and T2DM patients, respectively. Among patients with T1DM and T2DM, 5.9% and 36.4%, respectively, did not know what hypoglycemia was at baseline, also high proportion of patients had impaired hypoglycemic awareness in the study (82.4% and 62.7%, respectively). Conclusion: overall, high proportion of patients reported hypoglycemic events in the prospective period indicating under reporting during the retrospective period due to recall bias. Therefore, there is a need for patient education program to improve the awareness of hypoglycemia in diabetes patient in Indonesia.

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Latar belakang: hipoglikemia merupakan efek samping utama dari terapi insulin pada pasien diabetes melitus. Penelitian ini dilakukan untuk mengevaluasi kejadian hipoglikemia pada pasien diabetes melitus tipe 1 (T1DM) atau diabetes melitus tipe 2 (T2DM) yang diobati dengan insulin pada kohort Indonesia.

Metode: penelitian kohort Indonesia ini terdiri dari evaluasi retrospektif dan prospektif terhadap episode hipoglikemik, dengan menggunakan International Operations Hypoglycemia Assessment Tool (IO HAT) pada 374 pasien diabetes Indonesia (T1DM; n=17 dan T2DM; n=357). Pasien berusia ≥18 tahun dan diobati dengan insulin selama >12 bulan dipilih untuk penelitian ini (ClinicalTrials.gov nomor: NCT02306681).

Hasil: sebanyak 374 pasien disertakan untuk studi ini dan menyelesaikan self assessment questionnaire 1 (SAQ1). Semua pasien T1DM (17 [100%]) dan 347 pasien T2DM (97,2%) menyelesaikan SAQ2. Hampir semua pasien dalam 4 minggu periode prospektif melaporkan setidaknya satu kejadian hipoglikemi (T1DM 100%, T2DM 99,4%) dan tingkat kejadian hipoglikemia adalah 67,5 kejadian per pasien-tahun (PPY) dan 25,7 kejadian PPY masing-masing untuk pasien T1DM dan T2DM. Diantara pasien dengan T1DM dan T2DM, 5,9% dan 36,4%, masing-masing, tidak mengetahui apa hipoglikemia pada awal penelitian. Tercatat proporsi yang tinggi dari pasien memiliki kesadaran yang buruk akan kejadian hipoglikemi (82,4% dan 62,7%, masing-masing).

Kesimpulan: secara keseluruhan, proporsi yang tinggi dari pasien yang melaporkan kejadian hipoglikemi pada periode prospektif mengindikasikan kurang pelaporan selama periode retrospektif karena bias ingatan (recall bias). Oleh karena itu dibutuhkan program pendidikan pasien untuk meningkatkan kesadaran akan hipoglikemia dari pasien diabetes di Indonesia"

"Hipoglikemia merupakan salah satu komplikasi diabetes melitus tipe 2. Anggota keluarga biasanya menjadi orang pertama yang mengetahui kejadian hipoglikemia pada klien. Penelitian ini bertujuan untuk mengetahui pengalaman keluarga klien diabetes melitus tipe 2 menghadapi hipoglikemia. Penelitian ini adalah penelitian kualitatif dengan desain fenomenologi deskriptif. Wawancara mendalam terhadap 11 partisipan mengidentifikasi empat tema yaitu: keluarga mempersepsikan hipoglikemia adalah sesuatu yang biasa, keluarga mampu mengenali gejala awal hipoglikemia, keluarga memberikan dukungan positif bagi klien dalam menghadapi hipoglikemia, dan hipoglikemia memiliki dampak negatif bagi keluarga. Hasil penelitian menunjukkan peran penting perawat untuk memberikan edukasi yang komprehensif mengenai hipoglikemia terhadap keluarga klien diabetes melitus tipe 2.

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Hypoglycemia is one of diabetes complications. Hypoglycemia can increase risk of cardiovascular diseases or even lead to death. Family members are usually the first people to recognize hypoglycemia. Hypoglycemia is an unpredictable condition which make they should aware with it. A qualitative study using a phenomenological description design was utilized. In depth interviews were conducted with 11 family members of the person with type 2 diabetes. Family rsquo s experiences dealing with hypoglycemia were described into four main themes family perceive hypoglycemia is a common thing, family is capable in recognizing early symptoms of hypoglycemia, family provide positive support to person dealing with hypoglycemia, and hypoglycemia affects the family negatively. This study denotes a major role of nurse to provide a comprehensive education about hypoglycemia to the family of the person type 2 diabetes."

"Salah satu kelompok penyakit metabolik yang terjadi karena kelainan sekresi insulin, kerja insulin atau keduanya adalah Diabetes Melitus (DM) yang ditandai dengan hiperglikemia. Kondisi hiperglikemia yang berkepanjangan menyebabkan DM menjadi salah satu masalah kesehatan yang besar di seluruh dunia karena komplikasinya dapat muncul secara akut maupun kronik. Perawat berperan penting dalam menurunkan angka morbiditas dan mortalitas melalui Diabetes Self- Management Education (DSME) dan Diabetes Self-Management Support (DSMS) untuk mencegah komplikasi dan membantu meningkatkan perubahan gaya hidup yang penting bagi individu. Penerapan DSME dan DSMS dapat dilakukan perawat dengan mengaplikasikan teori Self Care Dorothea Orem pada proses keperawatan. Penerapan teori ini berfokus pada kemampuan individu dalam melakukan tindakan keperawatan mandiri, mengenali dan mengatur kebutuhan perawatannya. Penerapan evidence based practice sesuai program DSME dan DSMS dalam upaya meningkatkan self care pasien DM adalah melalui penggunaan buku harian Pemantauan Gula Darah Mandiri (PGDM). Proyek inovasi latihan kekuatan otot dan keseimbangan dilakukan pada pasien DM lansia untuk mencegah jatuh, meningkatkan kekuatan otot dan keseimbangan berjalan.

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One of metabolic diseases that occurs due to abnormalities in insulin secretion, insulin action or both is diabetes mellitus (DM). It is characterized by hyperglycemia. Prolonged of hyperglycemia causes various complication become major health problem worldwide. Nurses play an important role in reducing morbidity and mortality through the Diabetes Self-Management Education (DSME) and Diabetes Self-Management Support (DSMS) to prevent the complications and improve lifestyle changes. Framework of DSME and DSMS were applied using Dorothea Orem's Self Care. The application of this theory focuses on the individual's ability to independently perform nursing actions, identify and manage the treatment needs. Evidence-based practice related to DSME and DSMS programs by using Self Monitoring Blood Glucose Diary (SMBG). The inovation project was muscle strengths and balances exercises in elderly diabetic patients with neuropathy, in other to prevent falls and improve the muscle strengths and balances."

"Hipoglikemia adalah komplikasi akut diabetes melitus yang seringkali terjadi secara berulang yang ditandai dengan gula darah kurang dari 70 mg/dl. Kondisi tersebut akan berdampak secara psikologis yaitu ketakutan akan serangan ulang yang menciptakan perasaan traumatis pada penyandang diabetes melitus. Penelitian ini bertujuan untuk memperoleh pemahaman yang mendalam tentang pengalaman penyandang diabetes melitus yang pernah mengalami episode hipoglikemi di Persadia Kota Depok. Penelitian ini merupakan penelitian kualitatif deskriptif dengan pendekatan fenomenologi terhadap enam partisipan. Hasil penelitian didapatkan enam tema utama yaitu penurunan fungsi fisik sementara sebagai respon hipoglikemia, perasaan traumatis ketika mengalami hipoglikemia, pemahaman partisipan terhadap penyebab hipoglikemia, kesadaran untuk pencegahan hipoglikemia, keyakinan internal menjadi sumber koping utama dalam menghadapi hipoglikemia, kebutuhan pelayanan keperawatan. Hasil penelitian ini diharapkan dapat menjadi masukan dalam meningkatkan edukasi pada pasien yang mengalami hipoglikemia.

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Hypoglycemia is an acute complication of diabetes mellitus which frequently occur repeatedly marked by blood glucose less than 70 mg/dl. The condition will affect the psychological fear of repeated attacks that create a traumatic feelings in people with diabetes mellitus. This study aims is to gain an in depth understanding of experiences of persons with diabetes mellitus who had experienced of hypoglycemia episodes in Persadia Depok. Qualitative descriptive phenomenology approach was applied to 6 participants. The findings revealed 6 themes: decline in physical function while in response to hypoglycemia, traumatic feelings when experiencing hypoglycemia, participants understanding that caused of hypoglycemia, awareness of hypoglycemia prevention, internal beliefs became the main source of coping to faced of hypoglycemia and nursing care needs. The results of this study suggest a need of improvement in nursing education for patients with hypoglycemia."

"Latar Belakang. Hipoglikemia berat di pasien diabetes melitus tipe 2 (DMT2) saat ini sering dihubungkan dengan peningkatan mortalitas, kejadian kardiovaskular, dan penurunan fungsi kognitif.Tujuan. Tujuan penelitian ini adalah untuk membuat model prediksi untuk hipoglikemia berat pada pasien DMT2 rawat jalan di pusat kesehatan nasional tersier.Metode. Penelitian ini merupakan penelitian kohort retrospektif yang dilaksanakan di Poliklinik Metabolik-Endokrin Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo. Semua pasien DMT2 dewasa (berusia ≥18 tahun) yang sudah mejalani kontrol selama setidaknya 1 tahun diikutsertakan sebagai subjek penelitian. Data mengenai kejadian hipoglikemia berat dalam 1 tahun terakhir dikumpulkan dari anamnesis dengan subjek penelitian, sedangkan variabel bebas (meliputi usia, tingkat pendidikan, pemahaman mengenai gejala hipoglikemia, HbA1C, lama DMT2, penyakit ginjal kronik, penyakit hati kronik, riwayat hipoglikemia, penerapan pemantauan gula darah mandiri, penggunaan sulfonilurea, dan penggunaan insulin) diambil dari data rekam medis pasien 1 tahun sebelum pengumpulan data.Hasil. Penelitian ini berhasil mengumpulkan 291 subjek, dengan insidensi kejadian hipoglikemia berat 25,4%. PGK std. V (adjusted-OR 9,84 [IK95% 1,68-57,62]; p=0,011); riwayat hipoglikemia berat (adjusted-OR 5,60 [IK95% 2,94-10,69]; p<0,001); dan penggunaan insulin (adjusted-OR OR 2,60 [IK95% 1,31-5,15]; p=0,006) memiliki asosiasi yang bermakna secara statistik terhadap peningkatan risiko hipoglikemia berat. Model prediksi yang dibuat berdasar variabel tersebut mampu menunjukkan validasi yang baik dengan AUROC sebesar 0,742 (IK95% 0,67-0,81); p<0,001.Kesimpulan. Sebagian besar subjek DMT2 mengalami setidaknya 1 episode hipoglikemia berat. Riwayat hipoglikemia berat, penggunaan insulin, dan PGK std. V memiliki asosiasi yang bermakna terhadap risiko hipoglikemia berat.

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Background. Severe hypoglycemia in type 2 diabetes mellitus (T2DM) patients is often associated with inreased mortality and cardiovascular events, as well as decreased cognitive function.

Aim. The objective of this study is to develop a prediction model for severe hypoglycemia in T2DM patients in a tertiary care hospital in Indonesia.

Method. This study is a retrospective cohort study in endocrinology out-patient clinic in Dr. Cipto Mangunkusumo National General Hospital. All subjects ≥18 years of age who had been visiting the clinic for at least a year were included. Subjects were interviewed whether they had any events of severe hypoglycemia within the last 1 year; while independent variables (including age, education level, patients’ understanding of hypoglycemia symptoms, HbA1C level, duration of T2DM, chronic kidney disease, chronic liver disease, history of severe hypoglycemia, self-monitoring blood glucose application, sulfonylurea use, and insulin use) were taken from medical records 1 year prior from data collection.

Result. We collected 291 subjects, among whom incidence of severe hypoglycemia was 25.4%. Stg. V CKD (adjusted-OR 9.84 [95%CI 1.68 to 57.62]; p=0.011); history of severe hypoglycemia (adjusted-OR 5.60 [95%CI 2.94 to 10.69]; p<0.001); and insulin use (adjusted-OR 2.60 [95%CI 1.31 to 5.15]; p=0.006) were associated with increased risk of severe hypoglycemia. Using those variables, our model yielded an AUROC of 0.742 (95%CI 0.67 to 0.81); p<0.001.

Conclusion. High proportion of T2DM subjects suffered at least one episode of severe hypoglycemia. History of severe hypoglycemia, insulin use, and stg. V CKD were associated with the risk of severe hypoglycemia. "

"ABSTRAK Latar Belakang. Prevalensi disfungsi tiroid lebih tinggi pada pasien diabetes dibandingkan populasiumum. Hipotiroidisme memperburuk komplikasi, morbiditas, mortalitas, dan kualitas hidup pasiendiabetes melitus tipe 2 (DM tipe 2). Faktor risiko hipotiroidisme pada pasien DM tipe 2 selama ini masihkontradiktif dan belum dikaji secara lengkap. Keberadaan sistem skor hipotiroidisme pada pasien DMtipe 2 diperlukan untuk membantu diagnosis dan menapis pasien DM tipe 2 yang memerlukanpemeriksaan 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). Analisisdata dilakukan dengan program statistik SPSS Statistics 17.0 untuk analisis univariat, bivariat,multivariat, dan Receiving Characteristics Operator (ROC) dan SPSS Statistics 20.0 untuk analisisbootstrapping pada Kalibrasi Hosmer-Lemeshow.Hasil. Sebanyak 303 subjek dianalisis untuk mendapatkan proporsi disfungsi tiroid dan 299 subjekdianalisis untuk mendapatkan determinan hipotiroidisme. Sebanyak 23 subjek (7,59%) terdiagnosishipotiroidisme, terdiri dari 43,5% subjek hipotiroid klinis dan 56,5% subjek hipotiroid subklinisberdasarkan Indeks Zulewski dan/atau Indeks Billewicz, dengan 16,7% hipotiroid klinis dan 83,3%hipotiroid subklinis berdasarkan hasil pemeriksaan fT4. Determinan hipotiroidisme pada pasien DMtipe 2 adalah riwayat penyakit tiroid di keluarga dengan OR sebesar 4,719 (95% IntervalKepercayaan/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 metabolikOR 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 pasienDM tipe 2. ABSTRACT Background. Prevalence of thyroid dysfunction is greater in diabetes patients compared to generalpopulation. Hypothyroidism is worsening complications, morbidity, mortality, and quality of life in type2 diabetes mellitus (T2DM) patients. Risk factors of hypothyroidism in T2DM patients are stillcontradictive and not assessed completely. Presence of scoring system to estimate hypothyroidism inT2DM patients are needed to help diagnosing and screening of T2DM patients who need to undergothyroid 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 ClinicCipto Mangunkusumo Hospital from July-September 2015 with consecutive sampling method. Allsubjects underwent interview, physical examination, and laboratory testing (TSH and fT4). Analysiswas done by using SPSS Statistics 17.0 for univariate, bivariate, multivariate, and ROC (ReceivingOperator Characteristics) analysis and SPSS Statistics 20.0 for bootstrapping analysis in HosmerLemeshowCalibration. Results. 303 subjects included for proportion study of thyroid dysfunction and 299subjects included for analysis of hypothyroidism determinants. 23 subjects (7,59%) are diagnosed as havinghypothyroidism, consisted of 43,5% clinical hypothyroidism and 56,5% subclinical hypothyroidismbased on clinical scoring index by Zulewski and Billewicz, and 16,7% subjects as having clinicalhypothyroidism 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 componentsof 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 iscalled RSCM Hypothyroid Score is expected to be a tool for helping diagnosis of hypothyroidism inT2DM patients.;Background. Prevalence of thyroid dysfunction is greater in diabetes patients compared to generalpopulation. Hypothyroidism is worsening complications, morbidity, mortality, and quality of life in type2 diabetes mellitus (T2DM) patients. Risk factors of hypothyroidism in T2DM patients are stillcontradictive and not assessed completely. Presence of scoring system to estimate hypothyroidism inT2DM patients are needed to help diagnosing and screening of T2DM patients who need to undergothyroid 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 ClinicCipto Mangunkusumo Hospital from July-September 2015 with consecutive sampling method. Allsubjects underwent interview, physical examination, and laboratory testing (TSH and fT4). Analysiswas done by using SPSS Statistics 17.0 for univariate, bivariate, multivariate, and ROC (ReceivingOperator Characteristics) analysis and SPSS Statistics 20.0 for bootstrapping analysis in HosmerLemeshowCalibration. Results.303subjectsincludedforproportionstudyofthyroiddysfunctionand299subjectsincludedforanalysis of hypothyroidism determinants. 23 subjects (7,59%) are diagnosed as havinghypothyroidism, consisted of 43,5% clinical hypothyroidism and 56,5% subclinical hypothyroidismbased on clinical scoring index by Zulewski and Billewicz, and 16,7% subjects as having clinicalhypothyroidism 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 componentsof 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 iscalled RSCM Hypothyroid Score is expected to be a tool for helping diagnosis of hypothyroidism inT2DM patients.;Background. Prevalence of thyroid dysfunction is greater in diabetes patients compared to generalpopulation. Hypothyroidism is worsening complications, morbidity, mortality, and quality of life in type2 diabetes mellitus (T2DM) patients. Risk factors of hypothyroidism in T2DM patients are stillcontradictive and not assessed completely. Presence of scoring system to estimate hypothyroidism inT2DM patients are needed to help diagnosing and screening of T2DM patients who need to undergothyroid 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 ClinicCipto Mangunkusumo Hospital from July-September 2015 with consecutive sampling method. Allsubjects underwent interview, physical examination, and laboratory testing (TSH and fT4). Analysiswas done by using SPSS Statistics 17.0 for univariate, bivariate, multivariate, and ROC (ReceivingOperator Characteristics) analysis and SPSS Statistics 20.0 for bootstrapping analysis in HosmerLemeshowCalibration. Results.303subjectsincludedforproportionstudyofthyroiddysfunctionand299subjectsincludedforanalysis of hypothyroidism determinants. 23 subjects (7,59%) are diagnosed as havinghypothyroidism, consisted of 43,5% clinical hypothyroidism and 56,5% subclinical hypothyroidismbased on clinical scoring index by Zulewski and Billewicz, and 16,7% subjects as having clinicalhypothyroidism 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 componentsof 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 iscalled RSCM Hypothyroid Score is expected to be a tool for helping diagnosis of hypothyroidism inT2DM patients."

"Background: thyroid dysfunction is more likely to occur in diabetes mellitus patients than general population. Until now, no study has been done to find prevalence of hypothyroidism and hyperthyroidism in Indonesian diabetics. This study aimed to find the proportion and characteristics of thyroid dysfunction in Indonesian type 2 diabetes mellitus patients. Methods: a cross-sectional study was conducted in Endocrine and Diabetes Polyclinic, Department of Internal Medicine, Cipto Mangunkusumo Hospital from July to September 2015. This study include type 2 diabetes mellitus patients, age ≥ 18 year-old, willing to undergo thyroid laboratory testing. In this study, hypothyroidism defined as TSH more than 4.0 mIU/L, while hyperthyroidism is defined as TSH less than 0.4 mIU/L with eCLIA. Results: from 364 subjects who were recruited from Endocrine and Diabetes Polyclinic, Cipto Mangunkusumo Hospital, 303 subjects underwent this study until analysis. Two hundred and three (273) subjects (90.1%) were euthyroid, 7 subjects (2.31%) were hyperthyroid, and 23 subjects (7.59%) were hypothyroid. Majority of the patients had subclinical hypothyroidism (56.5% based on Zulewski and Billewicz Score and 65.2% based on fT4 laboratory result), while 42.9% and 71.4% subjects had clinical hyperthyroidism based on clinical appearance and fT4 laboratory result respectively. Conclusion: proportion of hypothyroidism was 7.59% and hyperthyroidism was 2.31%, while the proportion of total thyroid dysfunction was 9.9% among diabetics. It is suggested that screening for thyroid dyscfunction can be done in high risk condition as a part of comprehensive management in type 2 diabetes mellitus patients.

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Latar belakang: disfungsi tiroid lebih banyak terjadi pada pasien diabetes dibandingkan populasi umum. Sampai saat ini belum ada penelitian yang menemukan prevalensi hipotiroidisme dan hipertiroidisme pada pasien diabetes mellitus di Indonesia. Tujuan penelitian ini adalah menemukan proporsi dan karakteristik disfungsi tiroid pada pasien diabetes melitus tipe 2 di Indonesia.

Metode: penelitian potong lintang dilakukan di Poliklinik Endokrin dan Diabetes Departemen Ilmu Penyakit Dalam Rumah Sakit Cipto Mangunkusumo pada bulan Juli hingga September 2015. Penelitian ini mengikutsertakan pasien diabetes melitus tipe 2, usia di atas 18 tahun, dan bersedia melakukan pemeriksaan laboratorium fungsi tiroid. Dalam penelitian ini, hipotiroidisme didefinisikan TSH lebih dari 4,0 mIU/L, sementara hipertiroidisme didefinisikan TSH kurang dari 0,4 mIU/L menggunakan metode eCLIA. Hasil: dari 364 subjek yang direkrut di Poliklinik Endokrin dan Diabetes Rumah Sakit Cipto Mangunkusumo, sebanyak 303 subjek mengikuti penelitian hingga analisis. Dua ratus tujuh puluh tiga (273) (90,1%) subjek eutiroidisme, 7 (2,31%) subjek hipertiroidisme, dan 23 (7,59%) subjek hipotiroidisme. Sebagian besar subjek termasuk hipotiroidisme subklinis (56,5% berdasarkan Index Zulewski dan Billewicz, 65,2% berdasarkan pemeriksaan fT4), sementara 42,9% dan 71,4% subjek termasuk kategori hipertiroidisme klinis masing-masing berdasarkan tampilan klinis dan pemeriksaan fT4.

Kesimpulan: pada pasien diabetes melitus tipe 2, proporsi hipotiroidisme adalah 7.59% dan proporsi hipertiroidisme adalah 2.31% sehingga secara total, disfungsi tiroid memiliki proporsi sebesar 9.9%. Disarankan skrining fungsi tiroid dilakukan pada pasien risiko tinggi sebagai manajemen komprehensif pasien diabetes melitus tipe 2"

"Penelitian ini bertujuan untuk mengetahui hubungan antara profil lipid darah dengan derajat retinopati diabetik penderita DM tipe-2. Penelitian potong-lintang pada 52 pasien retinopati diabetika dilaksanakan di Poliklinik Mata, Rumah Sakit Cipto Mangunkusumo, Jakarta. Data yang dikumpulkan meliputi data demografi, gaya hidup, lama menderita DM, pemeriksaan fisik dan antropometrik, asupan lemak, asam lemak dan kolesterol data kadar gula darah puasa, A1C, kolesterol total, kolesterol-LDL, kolesterol-HDL and trigliserida, dan pemeriksaan fundus. Analisis statistik yang digunakan adalah uji chi-square untuk mengetahui hubungan antara profil lipid darah dengan derajat retinopati diabetik. Subyek terdiri dari 20 orang laki-laki dan 32 orang perempuan dengan rerata usia 53,8 ± 5,2 tahun. Sebanyak 53,8% telah didiagnosis DM selama >10 tahun, dengan rerata IMT adalah 24,1 ± 3,3 kg/m2 dan 38,5% diklasifikasikan sebagai obes I dan II. Rerata kadar gula darah puasa 157,5 ± 71,8 mg/dL, dan A1C 9,1 ± 2,4 %. Sebanyak 40,4% subyek mempunyai kadar kolesterol total darah tinggi, 34,6% kadar kolesterol-LDL darah sangat tinggi, dan 65,4% dengan kolesterol-HDL dan trigliserida darah normal. Derajat keparahan retinopati diabetika ditunjukkan dengan adanya 61,6% subyek dengan retinopati diabetika non-proliferasi berat (NPDR) and retinopati diabetika proliferasi (PDR). Kesimpulannya, belum dapat dibuktikan adanya hubungan yang bermakna antara profil lipid dengan derajat retinopati diabetika.

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This study aimed to determine the relationship between plasma lipid profile and the severity of diabetic retinopathy in type 2 diabetes patients. A cross sectional study was done in Ophthalmologic Clinic, Cipto Mangunkusumo General Hospital, Jakarta for 52 diabetic retinopathy (DR) patients. Data collected were demographic, life style, duration of diabetes, physical and antropometric examinations, fat, fatty acid and cholesterol intake, fasting plasma glucose, A1C, total-, LDL-, HDL-cholesterol and triglyceride level, and fundus examination.

Statistical analysis was done using chi-square test to see the associations between plasma lipid profile and DR in type 2 diabetes patients. Subjects comprised of 20 males and 32 females diabetes patients with mean age of 53.8 ± 5.2 years. As much as 53.8% had been diagnosed as DM for >10 years. The mean value of BMI was 24.1 ± 3.3 kg/m2 and 38.5% were classified as obese I and II. The mean value of fasting plasma glucose was 157.5 ± 71.8 mg/dL, and A1C was 9.1 ± 2.4 %.

For lipid profile, 40.4% had high total cholesterol level (>240 mg/dL), 34.6% had high and very high LDL-cholesterol level (≥160 mg/dL), and 65.4% had normal HDL-cholesterol (40-60 mg/dL) and triglyceride level (<150 mg/dL). For the severity of retinopathy, 61.6% had severe non-proliferative diabetic retinopahy (NPDR) and proliferative diabetic retinopahy (PDR). In conclusion, there were no significant associations between plasma lipid profile and the severity of diabetic retinopathy."