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

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

"Latar Belakang/Tujuan: Premature cellular senescence yang sering dikaitkan pada kondisi Diabetes Mellitus tipe 2 (DMT2) dapat meningkatkan berbagai risiko penyakit terkait usia. Time restricted feeding sebagai contoh puasa Ramadhan ditengarai dapat menghambat proses penuaan. Sejauh ini, telah banyak studi yang menilai efek puasaRamadhan terhadap berbagai parameter metabolik dan antropometrik, namun belum ada studi yang mengevaluasi efek puasa Ramadhan terhadap biomarker aging yang dinilai melalui panjang telomer leukosit relatif (TLR).Metode: Studi dengan desain potong lintang dan kohort retrospektif pada subjek DMT2dan subjek non-DM berusia 40 – 60 tahun yang menjalani ibadah puasa Ramadhan setidaknya selama minimal 14 hari pada bulan Mei – Juli 2018 dan bulan Mei – Juli 2019. Perbedaan rerata panjang TLR antar subjek DMT2 dan non-DM dianalisis denganuji Mann Whitney sedangkan perbedaan rerata TLR pada subjek DMT2 yang berpuasa dianalisis dengan uji Wilcoxon.Hasil: Pada 39 subjek DMT2 dan 36 subjek non-DM subjek DMT2 yang ikut dalam penelitian ini didapatkan pemendekan panjang TLR yang bermakna pada subjek DMT2dibandingkan dengan subjek non-DM (0,436 (0,034 –1,472) vs 1,905 (0,615 –12,380), p =0,000) dan didapatkan pemanjangan panjang TLR yang tidak bermakna pada 48 subjek DMT2 yang menjalani puasa minimal 14 hari (0,391 (0,021 – 1,515) vs 1,117(0,528 –1,741), p=0,112), namun bermakna secara klinis.Kesimpulan: Pada subjek DMT2 terjadi pemendekan panjang TLR yang secara statistik bermakna dibandingkan subjek non-DM sedangkan pada subjek DMT2 yang menjalani puasa Ramadan didapatkan pemanjangan panjang TLR yang tidak bermaknasecara statistik namun bermakna secara klinis.

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Background/Aim: Premature cellular senescence which is often associated with type 2

diabetes mellitus (T2DM) can increase the risk of various age-related diseases. Time

restricted feeding such as Ramadhan fasting hypotesized could delay the aging process.

So far, there have been many studies assessing the effects of Ramadan fasting on various metabolic and anthropometric parameters, but no studies have evaluated the effect of Ramadhan fasting on aging biomarkers assessed by the relative telomere leucocyte length.

Method: An observational comparative dan cohort retrospective study was conducted from May to July 2018 and May to July 2019 on 40 – 60 years old T2DM and non-DM subjects. The mean difference between TD2M and control was analysed using Mann Whitney test and the mean difference relative telomere length in subjects with T2DM who underwent at least 14 days of Ramadan fasting was analyzed using Wilcoxon test.

Results: A total of 36 subjects with type 2 diabetes dan 39 subjects non-DM who enrolled in this study, there were a significant decrease relative leucocyte telomere in

subjects with type 2, compared with controls (0,436 (0,034 – 1,472) vs 1,905 (0,615 – 12,380), p =0,000) but there were statitically insignificant but clinically significant increase relative leucocyte telomere in subject with type 2 diabetes who underwent Ramadhan fasting at least 14 days (0,391 (0,021–1,515) vs 1,117 (0,528–1,741), p=0,112.

Conclusions: In T2DM subjects, there were a statistically significant decrease relative

leucocyte telomere compared with controls while there were statitically insignificant but

clinically significant increase relative leucocyte telomere in subject with type 2 diabetes who underwent Ramadhan fasting."

"Hingga saat ini, belum ada penanda biologis yang menggambarkan kondisi penyakit ginjal kronik (PGK) akibat diabetes melitus (DM) sejak dini. Studi ini bertujuan untuk mengetahui hubungan antara rasio albumin kreatinin urin (Urine Albumin Creatinine Ratio, UACR) dengan laju filtrasi glomerulus yang diestimasi (estimated Glomerular Filtration Rate, eGFR) sebagai penanda gangguan fungsi ginjal pada pasien DM tipe 2 RSUPN Dr. Cipto Mangunkusumo. Sampel urin dan serum diambil dari 18 subjek sehat dan 10 pasien DM tipe 2. Metode spektrofotometri digunakan untuk mengukur kadar albumin urin, kreatinin urin dan kreatinin serum. Data lain diperoleh dari kuesioner. Hasilnya, nilai eGFR pasien DM (68,85 ± 15,36 (Cockroft); 73,94 ± 16,30 (CKD-EPI)) lebih rendah dibandingkan dengan subjek sehat (90,51 ± 15,69, p < 0,01 (Cockcroft); 91,13 ± 21,21, p < 0,05 (CKD-EPI)), sedangkan nilai UACR pasien DM (314,99 ± 494,92) lebih tinggi dibandingkan dengan subjek sehat (0,48 ± 0,75, p < 0,01). Namun, tidak ditemukan hubungan yang bermakna antara UACR dengan eGFR pasien DM.

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Until now, no biological marker that describes the condition of chronic kidney disease (CKD) due to diabetes mellitus (DM) from the outset. This study aimed to determine the relationship between urine albumin creatinine ratio (UACR) with estimated Glomerular Filtration Rate (eGFR) as a marker of renal dysfunction at type 2 diabetes mellitus patients at RSUPN Dr. Cipto Mangunkusumo. Urine and serum samples taken from 18 healthy subjects and 10 type 2 diabetic patients. Spectrophotometric methods used to measure levels of urinary albumin, urinary creatinine and serum creatinine. Other data obtained from questionnaires.

Results, eGFR values were lower in DM patients (68.85 ± 15.36 (Cockroft); 73.94 ± 16.30 (CKD-EPI)) compared with healthy subjects (90.51 ± 15.69, p < 0.01 (Cockcroft); 91,13 ± 21,21, p < 0,05 (CKD-EPI)), while the value of UACR in DM patients (314.99 ± 494.92) was higher than healthy subjects (0.48 ± 0.75, p < 0.01). However, there was no significant correlation between UACR with eGFR of DM patients."

"ABSTRAKLatar Belakang: Puasa selama bulan Ramadhan adalah perubahan dalam gaya hidup untuk periode sebulan penuh yang rutin tiap tahunnya. Sejumlah penelitian menunjukkan terjadinya perubahan biokimia tubuh saat berpuasa baik pada pasien diabetes dan juga nondiabetes yang dapat mempengaruhi metabolisme glukosa dan sensitivitas insulin.Tujuan: Menilai pengaruh berpuasa selama Ramadhan terhadap perubahan kontrol glikemia, kadar Fetuin A, dan TNF-α dibandingkan sebelum dan sesudah puasa RamadhanMetode: Penelitian prospektif terhadap dua kelompok (diabetes dan non diabetes). Parameter kontrol glikemik, Fetuin A, dan TNF-α diukur 2-4 minggu sebelum berpuasa Ramadhan, minimal 14 hari puasa Ramadhan dan 4 minggu setelah puasa Ramadhan.Hasil: Puasa Ramadhan menurunkan glukosa darah puasa (GDP) secara signifikan pada kelompok Diabetes (D) (p=0,013) dan pada kelompok Non Diabetes (ND) (p=0,047), sedangkan serum Fetuin A turun tidak signifikan pada kelompok D (p=0,217) dan secara signifikan pada kelompok ND (p=0,009). Dan tidak ada perubahan yang signifikan kadar TNF-α pada kedua kelompok dibandingkan sebelum puasa Ramadhan (p=0,248, p=0,789). Pada 4 minggu setelah puasa Ramadhan,GDP kembali ke nilai yang tidak berbeda dari nilai dasar pada kedua kelompok, sementara Fetuin A secara signifikan lebih rendah pada kelompok diabetes (p=0,039) dan TNF-α lebih rendah secara signifikan pada kelompok ND (p=0,042) dari dari nilai dasar.Kesimpulan: Puasa selama Ramadahan memperbaiki kontrol glikemia pada kedua kelompok. Puasa Ramadhan juga mampu menurunkan nilai Fetuin A pada kedua kelompok, dan TNF-α pada kelompok ND

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ABSTRACTBackground: Fasting during Ramadan is a anually change in lifestyle for the period of a lunar month. Numerous studies have mentioned the biochemical alterations while fasting among both in nondiabetic patients and diabetic patients which can affect glucose metabolism and insulin sensitivity.Objective: to assess the impact of fasting during Ramadan on glycemic control, Fetuin A l, and TNF-a compared to before and after Ramadhan fastingMethods: Prospective Study of diabetic patients (D group) and non-diabetic subjects (ND group). Parameters of glycemic control, Fetuin A, and TNF-a were measured 2-4 weeks before Ramadan fasting, at least 14 days of Ramadan fasting and 4 weeks after Ramadan fasting.Results: Ramadan fasting reduced fasting blood glucose (FBG) significantly in D groups (p=0,013) and in the (ND) groups (p=0,047) , respectively, serum Fetuin A were lowered insignificantly in D groups (p=0,217) dan significantly in ND groups (p=0,009). And no significant differences of TNF-α level ini both group compared to before Ramadhan fasting (p=0,248, p=0,789). At 4 weeks post-Ramadhan fasting FBG returned to levels indistinguishable from their baseline values in both groups, while Fetuin A was maintained significantly lower in D groups (p=0,039) and TNF-α significantly lower in ND groups (p=0,042) from their baseline.Conclusions: Fasting during Ramadan improves glycemic control in both groups, Ramadan fasting was also able to reduce Fetuin A level in both groups, and TNF-α in the ND group."

"Obat antidiabetes yang paling banyak diresepkan di Puskesmas Indonesia adalah metformin atau kombinasi metformin dan sulfonilurea. Studi tentang metformin telah menunjukkan berbagai dampak penurunan kognitif pada pasien dengan diabetes mellitus tipe 2, sedangkan sulfonilurea telah terbukti mengurangi dampak ini. Penelitian ini bertujuan untuk membandingkan dampak metformin dan metformin-sulfonilurea pada fungsi kognitif dan menentukan faktor apa yang mempengaruhinya. Studi potong lintang ini dilakukan di Puskesmas Pasar Minggu dengan melibatkan 142 pasien diabetes melitus tipe 2 yang mengonsumsi metformin atau metformin-sulfonilurea selama >6 bulan dan usia >36 tahun. Fungsi kognitif dinilai menggunakan kuesioner Montreal Cognitive Assessment versi bahasa Indonesia. Efek dari metformin dan metformin-sulfonylurea pada penurunan kognitif tidak menunjukkan perbedaan yang signifikan, bahkan setelah mengontrol kovariat (aOR = 1,096; 95% CI =  13.008px;">0,523–2,297; nilai-p = 0,808). Analisis multivariat menunjukkan usia (OR = 4,131; 95% CI = 1,271–13,428; nilai-p = 0,018) dan pendidikan (OR = 2,746; 95% CI = 1.196–6.305; nilai-p = 0,017) mempengaruhi fungsi kognitif. Pendidikan yang lebih rendah dan usia yang lebih tua cenderung menyebabkan penurunan kognitif, tenaga kesehatan didorong untuk bekerja sama dengan ahli kesehatan masyarakat untuk mengatasi faktor risiko fungsi kognitif ini.

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The most prescribed antidiabetic drugs in Indonesian primary health care are metformin or a combination of metformin and sulfonylurea. Studies on metformin have shown various impacts on cognitive decline in patients with type 2 diabetes mellitus, whereas sulfonylurea has been shown to reduce this impact. This study aimed to compare the impacts of metformin and metformin-sulfonylurea on cognitive function and determine what factors affected it. This crosssectional study was conducted at Pasar Minggu Primary Health Care involving 142 type 2 diabetes mellitus patients taking metformin or metformin-sulfonylurea for >6 months and aged >36 years. Cognitive function was assessed using the validated Montreal Cognitive Assessment Indonesian version. The effects of metformin and metformin-sulfonylurea on cognitive decline showed no significant difference, even after controlling for covariates (aOR = 1.096; 95% CI = 0.523–2.297; p-value = 0.808). Multivariate analysis showed age (OR = 4.131; 95% CI = 1.271–13.428; p-value = 0.018) and education (OR = 2.746; 95% CI = 1.196–6.305; p-value = 0.017) affected cognitive function. Since a lower education and older age are likely to cause cognitive decline, health professionals are encouraged to work with public health experts to address these risk factors for cognitive function."

"Asupan serat pada penyandang DM tipe 2 maupun orang sehat di Indonesia rendah, meskipun berbagai penelitian membuktikan bahwa serat bermanfaat dalam memperbaiki profil lipid. Uji klinis acak menyilang ini bertujuan mengetahui pengaruh penambahan serat makanan terhadap profil lipid penyandang DM tipe 2 usia 20−64 tahun, dengan kadar serum kolesterol total >150 mg/dL, atau kolesterol LDL >100 mg/dL, atau kadar HDL < 45 mg/dL, atau trigliserida >150 mg/dL. Setiap subyek penelitian menjalani dua macam perlakuan diet selama 3 minggu, dengan wash out selama 1 minggu: diet DM sesuai rekomendasi PERKENI dengan makanan selingan berserat 5,88 g/hari. Dilakukan wawancara karakteristik demografi, pengukuran tinggi dan berat badan, penilaian asupan zat gizi dengan metode food record 3 x 24 jam serta pemeriksaan profil lipid sebelum dan setelah perlakuan. Rentang usia subyek penelitian 47-61 tahun, sebagian besar subyek adalah perempuan, dan tingkat pendidikan rendah, serta tingkat aktivitas fisik ringan, dengan status gizi obes I sebanyak 66%. Subyek dapat mengonsumsi makanan selingan berserat sebanyak 90% dari anjuran. Makanan selingan berserat dapat ditoleransi dengan baik, tanpa ada keluhan yang berarti. Sebagian besar subyek penelitian tidak dapat mengikuti anjuran diet DM nya, terutama dalam hal asupan protein, lemak, dan serat. Terlihat penurunan yang bermakna pada kadar serum kolesterol total (p=0,03) dan trigliserida (p=0,04) setelah konsumsi makanan selingan berserat. Kesimpulan: diet DM dengan konsumsi serat sebagai makanan selingan sebesar 5,88 g/hari menurunkan kadar serum kolesterol total dan trigliserida serum dibandingkan dengan diet DM pada penyandang DM tipe 2. Penelitian lanjutan dianjurkan dengan menambah serat dalam makanan selingan.

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Dietary fiber intake of type 2 Diabetes Mellitus (T2DM) patients and general Indonesian population were lower than recommendation, despite proven beneficial effect of dietary fiber on serum lipid profile. This randomized cross-over clinical trial aims to investigate the effect of 5,88 g/day fiber snack supplementation for 3 weeks on serum lipid profile among 20−64 years old T2DM patients with either serum concentration cholesterol total >150 mg/dL, cholesterol LDL >100 mg/dL, cholesterol HDL <45 mg/dL, or triglyceride >150 mg/dL.

Every subject underwent two treatments for 3 weeks with 1 week wash out: 5.88 g/day dietary fiber in snack bars integrated in diabetic diet recommended by Indonesian Diabetic Association (PERKENI). Assessments of sociodemographic, body height and weight, dietary intake using food record 3x24 hours method during study period, and lipid profile before and after intervention were performed.

Subjects age ranged 47-61 years, majority was female, low educational level, sedentary physical activity, and 66% obese. Subjects managed to consume 90% of the dietary fiber snack bars, without experiencing any side effects. Majority of subjects could not follow their diabetic dietary regimen, especially consumption of protein, fat and fiber. There were significant decreases total cholesterol (p=0.03) and triglyceride (p=0.04) serum concentrations after consumption of dietary fiber in snack bars.

Conclusion : diabetic diet with 5.88 g/day fiber snack decreases total cholesterol and triglyceride serum concentrations compared to diabetic diet alone in patients with T2DM. Further study to increase the amount of fiber in snack is proposed."

"Latar Belakang: Insidensi dan prevalensi diabetes melitus tipe 2 (DMT2) terus meningkat. Penurunan imunitas yang terjadi pada DMT2 dapat meningkatkan risiko infeksi. Kontrol gula darah yang baik bermanfaat dalam pengendalian infeksi dan pencegahan komplikasi makro dan mikrovaskuler tetapi penelitian yang melibatkan pasien DMT2 usia lanjut masih belum konklusif. Serial kasus ini dilakukan untuk melihat efektivitas kontrol gula darah terhadap kesintasan pasien DMT2 yang dirawat di rumah sakit, dan untuk implementasi tatalaksana nutrisi sesuai kebutuhan dan kondisi klinis pasien. Metode: Pasien pada serial kasus ini berusia antara 47 ? 65 tahun. Penyulit infeksi pada keempat pasien ini yaitu gangren diabetikum, selulitis, dan sepsis dengan infeksi paru dan infeksi saluran kemih. Tatalaksana nutrisi pasien dilakukan sesuai dengan rekomendasi American Diabetes Association dan Therapeutic Lifestyle Changes disesuaikan dengan kondisi klinis dan toleransi pasien. Perhitungan kebutuhan nutrisi menggunakan rekomendasi untuk perawatan pasien sakit kritis bagi pasien yang dirawat di intensive care unit (ICU), dan menggunakan perhitungan dengan formula Harris-Benedict bagi yang dirawat di ruangan dengan faktor stres sesuai derajat hipermetabolisme pasien. Pasien dipantau selama 7 ? 11 hari. Edukasi diberikan kepada pasien dan keluarga selama perawatan dan saat akan pulang. Hasil: Dalam pemantauan, tiga pasien menunjukkan perbaikan klinis, toleransi asupan, dan laboratorium, dan dapat dipulangkan, sedangkan satu pasien meninggal dunia. Kesimpulan: Kontrol gula darah, asupan nutrisi yang adekuat, dan edukasi yang sesuai, dapat meningkatkan kesintasan pasien DMT2 dengan penyulit infeksi yang dirawat di rumah sakit.

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Background: The incidence and prevalence of type 2 diabetes mellitus (T2DM) is increasing. Immune disfunction in T2DM patient may increase the risk of infection. The appropriate blood glucose control has a benefit in infection control and macro and microvascular complication prevention. The Studies of glycaemic control included older patients did not find convincing evidence. The aim of this case series is to assess the association between glycaemic control and clinical outcome of hospitalized T2DM patient with comorbid infection, and to provide appropriate nutrition therapy based on individual nutrition needs.

Method: Patients in this case series were between 47 - 65 years old. There of those patients were diagnosed T2DM with comorbid gangrenous diabeticum, cellulitis, and sepsis with lung infection and urinary tract infection. Two patients need intensive care in ICU, and another patients in the ward. Two patients received nutrition therapy as critically ill condition, and the rest as American Diabetic Association recommendation, with basal calorie requirement were calculated using Harris-Benedict formula and stress factor suitable for metabolic changes. Monitoring was done for 7 - 11 days. Education was done for the patient and family during hospitalization and discharge planning.

Results: Three patients showed the improvement of clinical conditions, intake tolerance, and laboratory results, whatever one patient was pass away.

Conclusion: Glycaemic control, adequate nutrition intake, and intensive education, may improve survival rate in hospitalized T2DM patient with infection as comorbid."

"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."

"Latar belakang: Gangguan fungsi ginjal pada tahap awal sangat jarang diketahui karena belum memunculkan tanda dan gejala. Saat gangguan fungsi ginjal berkembang progresif dan muncul penyakit ginjal terminal hingga hemodialisis akan menyebabkan status kesehatan jemaah haji menjadi risiko tinggi dan dapat menjadi tidak memenuhi syarat istithaah. Perlu dilakukan evaluasi lebih awal dengan mengetahui faktor risiko yang berhubungan dengan gangguan fungsi ginjal seperti obesitas sentral untuk mendapatkan upaya pencegahan dan intervensi yang lebih menguntungkan. Tujuan: Mengetahui prevalensi gangguan fungsi ginjal dan hubungan obesitas sentral dengan gangguan gangguan fungsi ginjal pada jemaah haji penderita DM tipe 2. Metode: Penelitian ini menggunakan desain cross sectional terhadap 2.106 jemaah haji yang menderita DM tipe 2. Subyek diperoleh dari data sekunder Siskohatkes Shar'i Puskeshaji Kemenkes RI tahun 1438 H / 2017 M. Semua subyek dilakukan pemeriksaan kesehatan di puskesmas atau rumah sakit rujukan. Estimasi nilai LFG menggunakan persamaan CKD EPI untuk menentukan fungsi ginjal. Obesitas sentral ditentukan menggunakan indeks lemak visceral. Analisis menggunakan regresi logistik multivariat. Hasil: Nilai rata-rata estimasi LFG 78,63 ml/menit/1,72 m2. Prevalensi gangguan fungsi ginjal pada jemaah haji yang menderita DM tipe 2 sebesar 39,55%. Prevalensi gangguan fungsi ginjal pada Jemaah haji penderita DM tipe 2 dengan obesitas sentral adalah 29,17%. Obesitas sentral berhubungan signifikan secara statistik dengan gangguan fungsi ginjal pada jemaah haji penderita DM tipe 2. Nilai adjusted OR sebesar 1,45 (95% CI 1,19-1,77). Kesimpulan: Prevalensi gangguan fungsi ginjal pada jemaah haji yang menderita DM tipe 2 sebesar 39,55%. Obesitas sentral berhubungan secara signifikan dengan gangguan fungsi ginjal pada jemaah haji yang menderita DM tipe 2.

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Background: Impaired renal function in the early stages often not raised signs and symptoms. End-stage renal disease with hemodialysis will cause Indonesian pilgrims in high risk health status and does not meet istithaah requirements. Early detection of risk factors such as central obesity might be directed to benefit prevention dan intervention.

Objective: to estimate the prevalence of renal function impairment in type 2 DM and the association of central obesity with renal function impairment among Indonesian pilgrim with type 2 DM based on Siskohatkes shar'i 1438 H / 2017 M.

Methods: This cross sectional studi consisted of 2.106 Indonesian pilgrims with type 2 DM. The data was obtained from Siskohatkes 2017 of Pilgrimage Health Center, Ministry of Health. The variable data analyzed were creatinin serum, anthropometric, age, gender, smoking, family history of end-stage renal disease, blood pressure, HDL, LDL, trigliserida and uric acid. Renal function impairment was defined according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation to estimate Glomerulus Filtration Rate (eGFR). Central obesity was determined using visceral adiposity index (VAI). Multivariable logistic regression was used to analyze the association of central obesity and renal function impairment.

Result: The prevalence of renal function impairment in Indonesia pilgrim with type 2 DM was 39,55%. The mean of eGFR was 78,63 ml/min/1,72 m2. Central obesity was associated with renal function impairment (adjusted OR = 1,45; 95% CI 1,19-1,77).

Conclusion: The prevalence of renal function impairment in Indonesia pilgrim with type 2 DM was 39,55%. Central obesity was associated with renal function impairment."

"Asupan serat dalam menu harian penyandang diabetes masih rendah. Tujuan penelitian ini adalah mengetahui pengaruh penambahan serat dalam makanan selingan penyandang diabetes melitus (DM) 2 terhadap kadar glukosa darah. Penelitian ini merupakan studi eksperimental dengan desain menyilang alokasi acak pada 7 laki-laki dan 13 perempuan di Klinik Dokter Keluarga Kayu Putih Jakarta. Subyek penelitian dibagi dalam dua kelompok: kelompok kontrol mendapat anjuran diet DM dan kelompok perlakuan mendapat anjuran diet DM dan pemberian makanan selingan yang mengandung serat 6 gram/hari selama 3 minggu. Pemeriksaan kadar glukosa darah puasa dan 2 jam postprandial dilakukan pada awal dan akhir perlakuan. Status gizi obes didapatkan pada 55% subyek. Sebagian besar subyek tidak mematuhi anjuran diet DM: asupan lemak tinggi sedangkan asupan serat 7,0–13,7 g/hari. Pada awal penelitian, kadar glukosa darah puasa dan 2 jam postprandial serum kedua kelompok perlakuan tidak berbeda bermakna. Setelah periode perlakuan, perubahan kadar glukosa darah tidak bermakna, namun terlihat cenderung menurun pada kelompok perlakuan. Kesimpulan: pada penyandang DM tipe 2, pemberian makanan selingan yang mengandung serat 6 gram selama 3 minggu tidak menurunkan kadar glukosa darah puasa dan 2 jam postprandial serum.

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Fiber intake in the daily menu of diabetes patients was observed to be lower than recommendation. The aim of this study was to evaluate the effect of fiber supplementation as snack on blood glucose levels in type 2 diabetic subjects. This randomized, cross-over controlled clinical trial involved 7 men and 13 women, who visited to Family Doctor Clinic Kayu Putih in Jakarta. Subjects were assigned into two groups: control group who got diabetic diet recommendation, while treatment group got diabetic diet recommendation and snack containing 6 grams fiber/day for three weeks. Fasting blood glucose (FBG) and 2 hours postprandial blood glucose (PPBG) levels were assessed before and after intervention. Fifty five percent of the subjects were obese. Majority of subjects could not comply with diabetic regiment: high in fat, while fiber intakes was around 7.0–13.7 g/day. At baseline, FBG and PPBG levels were comparable. After intervention period, blood glucose level did not changed significantly, but tend to decrease in the treatment group. In conclusion: snack containing 6 grams of fiber for three weeks did not decrease FBG and PPBG of type 2 diabetic subjects."