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Endang Laelasari
Perbandingan efektivitas biaya antara terapi insulin, sulfonilurea dan sulfonilurea-biguanid pada pasien diabetes melitus tipe 2 RSK Dr. Sitanala Tangerang = Cost effectivness analysis of insulin sulfonylurea and sulfonylurea biguanid in type 2 diabetes mellitus in Dr. Sitanala leprosy hospital in Tangerang / Endang Laelasari
"ABSTRAK
Diabetes mellitus tipe 2 DMT2 adalah suatu kondisi ketika sel tubuh resisten terhadap insulin yang dihasilkan oleh sel ? pankreas. World Health Organization WHO memperkirakan prevalensi penderita DMT2 akan terus meningkat terutama di negara-negara berkembang termasuk Indonesia. Pengobatan diabetes jangka panjang, pola peresepan yang beragam dan perbedaan harga insulin dibandingkan sulfonilurea dan biaguanid menyebabkan perbedaan biaya yang dikeluarkan untuk terapi. Penelitian merupakan analitik deskriptif dengan desain cross sectional.Penelitian dilakukan untuk mengetahui efektivitas pengobatan dan efisiensi biaya antidiabetes pada pasien DMT2 rawat jalan di RSK Dr. Sitanala Tangerang pada periode April 2015 - Juni 2015 yang mengkomsumsi obat yang sama selama 4 bulan terakhir. Subjek penelitian dibagi menjadi tiga kelompok yaitu yang menggunakan insulin n=29 , yang menggunakan obat sulfonilurea n=29 dan yang menggunakan kombinasi sulfonilura-biguanid n=39 .Efektivitas pengobatan dilihat dari nilai HbA1c pasien dan analisis antidiabetes dari segi efektivitas pengobatan dan biaya dilakukan dengan menggunakan Cost Effectiveness Analysis CEA . Hasil penelitian menunjukkan bahwa pasien DMT2 berjenis kelamin perempuan lebih banyak dibandingkan pasien laki-laki yaitu 68 orang 65,96 dengan rata-rata usia pasien DMT2 yaitu 50-59 tahun. Efektivitas tertinggi dihasilkan oleh kombinasi sulfonilurea-biguanid yaitu 7,48 1,89. Nilai ACER Average cost effectiveness ratio kelompok insulin adalah Rp. 40.866, kelompok sulfonilurea adalah Rp. 1.369 dan kelompok kombinasi sulfonilurea-biguanid adalah Rp. 2.621. Nilai ICER incremental cost effectiveness ratio untuk terapi sulfonilurea-biguanid terhadap terapi sulfonilurea adalah Rp. 16.194. Berdasarkan analisis yang dilakukan, terapi kombinasi sulfonilurea-biguanid lebih cost effective dibandingkan terapi insulin ataupun terapi sulfonilurea tunggal.
ABSTRACT
Type 2 diabetes mellitus T2DM is a condition when the body cells are resistant to insulin produced by the pancreas cells. World Health Organization WHO estimates that the prevalence of type 2 diabetes will continue to increase, especially in developing countries, including Indonesia. Long term diabetes treatment, prescribing pattern varied and the price difference compared to sulfonylurea insulin and biaguanid cause differences in costs incurred for treatment. The research is descriptive analytic with cross sectional design.The study was conducted to examine the effectiveness and cost efficiency antidiabetic treatment in patients with type 2 diabetes outpatient Dr. Sitanala Leprosy Hospital in Tangerang in the period April 2015 June 2015 were consuming the same drug during the last 4 months. Subjects were divided into three groups who use insulin n 29 , which uses a sulfonylurea drug n 29 and those using sulfonilura biguanide combination n 39 .The effectiveness of treatment views of HbA1c values of patients and analysis of antidiabetic terms of the effectiveness of treatment and the cost is done by using the Cost Effectiveness Analysis CEA . Results showed that patients with type 2 diabetes were female more than male patients ie 68 65.96 with an average age of patients with type 2 diabetes that is 50 59 years. The highest effectiveness generated by the combination of sulfonylurea biguanide is 7.48 1.89. Value ACER Average cost effectiveness ratio insulin group is Rp. 40 866, sulfonylurea group is Rp. 1369 and the combination of sulfonylurea biguanide group is Rp. 2,621. Value ICER incremental cost effectiveness ratio for the treatment of sulfonylurea biguanide to sulfonylurea therapy is Rp. 16 194. Based on the analysis performed, sulfonylurea biguanide combination therapy is more cost effective than sulfonylurea insulin therapy or single therapy."
2017
T47346
UI - Tesis Membership  Universitas Indonesia Library
cover
Sylvia
Perbandingan efektivitas insulin sulfonilurea kombinasi sulfonilurea biguanid terhadap nilai hba1c dan elfg pasien diabetes melitus tipe 2 di rsk dr sitanala tangerang = Effectiveness comparison between insulin sulfonylurea biguanide combination and sulfonylurea on hba1c and egfr level of type 2 diabetes patient in rsk dr siatanala tangerang
"[ABSTRAK
Penelitian mengenai efektivitas pengobatan diabetes melitus dan kaitannya
dengan pencegahan komplikasi masih menujukkan hasil yang beragam. Penelitian
ini bertujuan untuk membandingkan efektivitas hipoglikemik dan fungsi ginjal
dari sulfonilurea, kombinasi sulfonilurea dan biguanid serta injeksi insulin. Disain
penelitian adalah kohort retrospektif pada pasien diabetes melitus tipe 2 rawat
jalan yang mengkonsumsi obat yang sama selama empat bulan terakhir di RSK
Dr. Sitanala Tangerang. Penelitian ini dilaksanakan pada kurun waktu April-Juni
2015, dan sudah mendapatkan lulus kaji etik dari Komite Etik rumah sakit ini.
Subyek penelitian dibagi kedalam tiga kelompok yaitu yang menggunakan injeksi
insulin (n = 30), yang menggunakan obat sulfonilurea tunggal (n = 30), dan
kombinasi sulfonilurea dan biguanid (n = 45). Efektivitas hipoglikemik dilihat
dari nilai HbA1C pasien dan komplikasi nefropati diabetik dilihat dari nilai eLFG
yang dihitung dari angka serum kreatinin. Rerata usia keseluruhan pasien adalah
54,98±7,47, sebagian besar adalah wanita (72%) dan cenderung overweight
(rerata IMT 25,47±4,77). Ada perbedaan yang bermakna (p = 0,042 ) pada nilai
HbA1C pasien kelompok kombinasi sulfonilurea-biguanid (rerata HbA1C
7,28±0,09) dibandingkan dengan kelompok insulin (rerata HbA1C 8,10±0,09),
sementara dengan kelompok sulfonilurea tunggal tidak ada perbedaan yang
bermakna. Sedangkan nilai eLFG untuk setiap kelompok obat tidak ditemukan
perbedaan yang bermakna. Subyek yang memiliki riwayat diabetes melitus dalam
keluarga mempunyai peluang 4,512 kali (interval kepercayaan 95%, p = 0,010)
lebih besar dibandingkan dengan yang tidak memiliki riwayat diabetes dalam
keluarga untuk memiliki nilai HbA1C lebih dari 7%. Pasien dengan IMT >30
kg/m2 mempunyai peluang sebesar 21,631 (p = 0,012) dibandingkan pasien
dengan IMT < 18,5 kg/m2 untuk memiliki nilai HbA1C yang tidak terkontrol atau
diatas 7%. Pengobatan dengan kombinasi antidiabetik oral sulfonilurea dan
biguanid lebih efektif dalam menurunkan nilai HbA1C pasien DM tipe 2
dibandingkan dengan insulin atau sulfonilurea tunggal, dan tidak ada perubahan
bermakna dalam penurunan fungsi ginjal ABSTRACT Research on effectiveness of therapy on diabetes mellitus associated with
prevention of its complication still remain varied in results. The hypoglycemic
effectiveness and the kidney function were compared between sulfonylurea,
sulfonylurea and biguanide combination and insulin, with the retrospective cohort
study design, on patients that use those agents in last four months and came to
out-patient clinic of RSK Dr. Sitanala Tangerang. This research had the Ethical
Clearance from the Ethical Committee of this hospital. Subjects were classify into
three groups, i.e insulin group (n = 30), sulfonylurea group (n = 30) and
sulfonylurea and biguanide combination group (n = 45). Hypoglycemic
effectiveness is measured with the HbA1C level and diabetic nephrophaty with
the eGFR which calculated from the measured serum creatinin. Mean age of all
subjects was 54,98±7,47 (p=0,157), most were women (72%, p=0,235), and tend
to overweight (mean BMI is 25,49±4,84; p = 0,59). Mean HbA1C level from the
sulfonylurea-biguanide (7,28±0,09) group were significantly different (p = 0,042)
with those from the insulin group (8,10±0,09), and there was no significant
difference with the sulfonylurea group. There was no significant difference in
diabetic nephropathy between groups. Subject with diabetic family history has
4,512 times chance to have the HbA1C level > 7% compare to those without
diabetic family history. Subjects with BMI >30 kg/m2 have 21,631 times chance
to get the HbA1C >7% compare to subjects with BMI <18,5 kg/m2. Sulfonylurea
and biguanide combination was more effective compare to insulin or sulfonylurea
monotherapy on decreasing HbA1C level of type 2 DM patients, without
significant difference in effect of lowering kidney functionH;Research on effectiveness of therapy on diabetes mellitus associated with
prevention of its complication still remain varied in results. The hypoglycemic
effectiveness and the kidney function were compared between sulfonylurea,
sulfonylurea and biguanide combination and insulin, with the retrospective cohort
study design, on patients that use those agents in last four months and came to
out-patient clinic of RSK Dr. Sitanala Tangerang. This research had the Ethical
Clearance from the Ethical Committee of this hospital. Subjects were classify into
three groups, i.e insulin group (n = 30), sulfonylurea group (n = 30) and
sulfonylurea and biguanide combination group (n = 45). Hypoglycemic
effectiveness is measured with the HbA1C level and diabetic nephrophaty with
the eGFR which calculated from the measured serum creatinin. Mean age of all
subjects was 54,98±7,47 (p=0,157), most were women (72%, p=0,235), and tend
to overweight (mean BMI is 25,49±4,84; p = 0,59). Mean HbA1C level from the
sulfonylurea-biguanide (7,28±0,09) group were significantly different (p = 0,042)
with those from the insulin group (8,10±0,09), and there was no significant
difference with the sulfonylurea group. There was no significant difference in
diabetic nephropathy between groups. Subject with diabetic family history has
4,512 times chance to have the HbA1C level > 7% compare to those without
diabetic family history. Subjects with BMI >30 kg/m2 have 21,631 times chance
to get the HbA1C >7% compare to subjects with BMI <18,5 kg/m2. Sulfonylurea
and biguanide combination was more effective compare to insulin or sulfonylurea
monotherapy on decreasing HbA1C level of type 2 DM patients, without
significant difference in effect of lowering kidney functionH;Research on effectiveness of therapy on diabetes mellitus associated with
prevention of its complication still remain varied in results. The hypoglycemic
effectiveness and the kidney function were compared between sulfonylurea,
sulfonylurea and biguanide combination and insulin, with the retrospective cohort
study design, on patients that use those agents in last four months and came to
out-patient clinic of RSK Dr. Sitanala Tangerang. This research had the Ethical
Clearance from the Ethical Committee of this hospital. Subjects were classify into
three groups, i.e insulin group (n = 30), sulfonylurea group (n = 30) and
sulfonylurea and biguanide combination group (n = 45). Hypoglycemic
effectiveness is measured with the HbA1C level and diabetic nephrophaty with
the eGFR which calculated from the measured serum creatinin. Mean age of all
subjects was 54,98±7,47 (p=0,157), most were women (72%, p=0,235), and tend
to overweight (mean BMI is 25,49±4,84; p = 0,59). Mean HbA1C level from the
sulfonylurea-biguanide (7,28±0,09) group were significantly different (p = 0,042)
with those from the insulin group (8,10±0,09), and there was no significant
difference with the sulfonylurea group. There was no significant difference in
diabetic nephropathy between groups. Subject with diabetic family history has
4,512 times chance to have the HbA1C level > 7% compare to those without
diabetic family history. Subjects with BMI >30 kg/m2 have 21,631 times chance
to get the HbA1C >7% compare to subjects with BMI <18,5 kg/m2. Sulfonylurea
and biguanide combination was more effective compare to insulin or sulfonylurea
monotherapy on decreasing HbA1C level of type 2 DM patients, without
significant difference in effect of lowering kidney functionH;Research on effectiveness of therapy on diabetes mellitus associated with
prevention of its complication still remain varied in results. The hypoglycemic
effectiveness and the kidney function were compared between sulfonylurea,
sulfonylurea and biguanide combination and insulin, with the retrospective cohort
study design, on patients that use those agents in last four months and came to
out-patient clinic of RSK Dr. Sitanala Tangerang. This research had the Ethical
Clearance from the Ethical Committee of this hospital. Subjects were classify into
three groups, i.e insulin group (n = 30), sulfonylurea group (n = 30) and
sulfonylurea and biguanide combination group (n = 45). Hypoglycemic
effectiveness is measured with the HbA1C level and diabetic nephrophaty with
the eGFR which calculated from the measured serum creatinin. Mean age of all
subjects was 54,98±7,47 (p=0,157), most were women (72%, p=0,235), and tend
to overweight (mean BMI is 25,49±4,84; p = 0,59). Mean HbA1C level from the
sulfonylurea-biguanide (7,28±0,09) group were significantly different (p = 0,042)
with those from the insulin group (8,10±0,09), and there was no significant
difference with the sulfonylurea group. There was no significant difference in
diabetic nephropathy between groups. Subject with diabetic family history has
4,512 times chance to have the HbA1C level > 7% compare to those without
diabetic family history. Subjects with BMI >30 kg/m2 have 21,631 times chance
to get the HbA1C >7% compare to subjects with BMI <18,5 kg/m2. Sulfonylurea
and biguanide combination was more effective compare to insulin or sulfonylurea
monotherapy on decreasing HbA1C level of type 2 DM patients, without
significant difference in effect of lowering kidney functionH, Research on effectiveness of therapy on diabetes mellitus associated with
prevention of its complication still remain varied in results. The hypoglycemic
effectiveness and the kidney function were compared between sulfonylurea,
sulfonylurea and biguanide combination and insulin, with the retrospective cohort
study design, on patients that use those agents in last four months and came to
out-patient clinic of RSK Dr. Sitanala Tangerang. This research had the Ethical
Clearance from the Ethical Committee of this hospital. Subjects were classify into
three groups, i.e insulin group (n = 30), sulfonylurea group (n = 30) and
sulfonylurea and biguanide combination group (n = 45). Hypoglycemic
effectiveness is measured with the HbA1C level and diabetic nephrophaty with
the eGFR which calculated from the measured serum creatinin. Mean age of all
subjects was 54,98±7,47 (p=0,157), most were women (72%, p=0,235), and tend
to overweight (mean BMI is 25,49±4,84; p = 0,59). Mean HbA1C level from the
sulfonylurea-biguanide (7,28±0,09) group were significantly different (p = 0,042)
with those from the insulin group (8,10±0,09), and there was no significant
difference with the sulfonylurea group. There was no significant difference in
diabetic nephropathy between groups. Subject with diabetic family history has
4,512 times chance to have the HbA1C level > 7% compare to those without
diabetic family history. Subjects with BMI >30 kg/m2 have 21,631 times chance
to get the HbA1C >7% compare to subjects with BMI <18,5 kg/m2. Sulfonylurea
and biguanide combination was more effective compare to insulin or sulfonylurea
monotherapy on decreasing HbA1C level of type 2 DM patients, without
significant difference in effect of lowering kidney functionH]"
Fakultas Farmasi Universitas Indonesia, 2015
T42968
UI - Tesis Membership  Universitas Indonesia Library
cover
Fitriyani
Analisis Efektivitas-Biaya Terapi Kombinasi Metformin-Insulin dan Metformin-Sulfonilurea pada Pasien Rawat Jalan dengan Diabetes Mellitus Tipe 2 di RSUPN Dr. Cipto Mangunkusumo = Cost-Effectiveness Analysis of Metformin-Insulin and Metformin-Sulfonylurea Combination Therapy in Outpatients with Type 2 Diabetes Mellitus at RSUPN Dr. Cipto Mangunkusumo.
"ABSTRAK
Diabetes mellitus (DM) tipe 2 diketahui sebagai salah satu masalah kesehatan yang memberikan beban ekonomi yang cukup besar pada sistem pelayanan kesehatan di seluruh dunia. Bervariasinya penggunaan terapi obat akan mengakibatkan adanya perbedaan dalam efektivitas dan biaya terapi, sehingga perlu dilakukan analisis efektivitas-biaya. Tujuan dari penelitian ini adalah menganalisis efektivitas-biaya terapi kombinasi metformin-insulin dan metformin-sulfonilurea pada pasien rawat jalan dengan DM tipe 2. Penelitian ini menggunakan desain studi kohort, pengambilan data dilakukan secara retrospektif di RSUPN Dr. Cipto Mangunkusumo menggunakan rekam medik pasien rawat jalan dengan DM tipe 2 dari tahun 2016-2019 dan data billing rumah sakit. Efektivitas terapi (∆HbA1c) dan biaya medis langsung antara kedua kelompok dibandingkan. ∆HbA1c antara kelompok metformin-insulin dan kelompok metformin-sulfonilurea tidak memiliki perbedaan yang bermakna secara statistik (rerata perbedaan 0,123%; p=0,608). Sedangkan median biaya medis langsung kelompok metformin-insulin lebih tinggi dibandingkan kelompok metformin-sulfonilurea (p < 0,001). Hasil analisis efektivitas-biaya menunjukkan bahwa terapi kombinasi metformin-sulfonilurea lebih cost-effective dibandingkan kombinasi metformin-insulin.
ABSTRACT
Type 2 diabetes mellitus (DM) has been recognized as one of the health problems that imposes economic costs to health care systems around the world. Variation of drug therapy will result in differences in effectiveness and cost of therapy, thus cost-effectiveness analysis has been regarded paramount. The purpose of this study is to analyze the cost-effectiveness of metformin-insulin and metformin-sulfonylurea combination therapy in outpatients with type 2 DM. This cohort study was conducted retrospectively at RSUPN Dr. Cipto Mangunkusumo using medical records of outpatients with type 2 DM from 2016-2019 and hospital billing. The effectiveness of therapy (∆HbA1c) and direct medical costs between the two groups were compared. ∆HbA1c between the metformin-insulin group and the metformin-sulfonylurea group did not have statistically significant differences (mean difference 0,123%; p=0,608). While the median of direct medical costs of the metformin-insulin group was higher than metformin-sulfonylurea group (p < 0.001). The results of the cost-effectiveness analysis showed that the combination therapy of metformin-sulfonylurea was more cost-effective compared to the combination of metformin-insulin."
2019
T55097
UI - Tesis Membership  Universitas Indonesia Library
cover
Fitri Wulandari
Analisis hidrogen peroksida urin serta hubungannya dengan estimasi LFG pada pasien diabetes melitus tipe 2 yang mengkonsumsi sulfonilurea dan kombinasi biguanid-sulfonilurea = Analysis of urinary hydrogen peroxide and its correlation with estimated GFR in type 2 diabetes mellitus patients consuming sulfonylurea and combination of biguanide-sulfonylurea
"[ABSTRAK
Gangguan fungsi ginjal yang sering terjadi pada pasien diabetes melitus tipe 2 diperankan oleh stres oksidatif. Belum diketahui efektivitas pengobatan diabetes melitus tipe 2 terhadap gangguan fungsi ginjal. Penelitian ini membandingkan dan menganalisis hubungan hidrogen peroksida urin yang merupakan produk stress oksidatif dan estimasi Laju Filtrasi Glomerulus (eLFG) pada kelompok pengobatan sulfonilurea dan kombinasi biguanid-sulfonilurea. Penelitian ini menggunakan desain penelitian kohort retrospektif dengan jumlah sampel 50 orang yang diambil di RSK Dr. Sitanala Tangerang dengan teknik total sampling. Nilai eLFG diperoleh berdasarkan nilai kreatinin serum yang diukur menggunakan metode kinetik Jaffe, sedangkan hidrogen peroksida urin menggunakan metode FOX (Ferrous ion Oxidation Xylenol Orange) 1. Nilai hidrogen peroksida urin pada dua kelompok pengobatan tidak memiliki perbedaan yang bermakna (p = 0,69). Sedangkan nilai eLFG pada dua kelompok juga tidak memiliki memiliki perbedaan yang bermakna dengan Cockroft Gault adalah p = 0,884; MDRD p = 0,886; dan CKDEP p= 0,490. Analisis hubungan hidrogen peroksida urin dengan eLFG berdasarkan persamaan MDRD dan CKDEPI menghasilkan hubungan positif bermakna (r = 0,326; p = 0,021) dan (r = 0,282; p = 0,047).
ABSTRACT
, Renal dysfunction which frequently occurs in type 2 diabetes mellitus patients caused by oxidative stress. The effectiveness of the type 2 diabetes mellitus treatment to renal dysfunction is unknown. This study compare and analyze the correlation between urinary hydrogen peroxide which is a product of oxidative stress and estimated glomerular filtration rate (eGFR) in the treatment groups of sulfonylurea and combination biguanide-sulfonylurea. This study used a retrospective cohort study design with 50 sampels that was taken in Dr. Sitanala Tangerang hospital with total sampling technique. Estimated GFR value obtained based on serum creatinine values were measured using a kinetic Jaffe method, while the urinary hydrogen peroxide using FOX (Ferrous ion Oxidation Xylenol Orange) 1. Value of urinary hydrogen peroxide in the two treatment groups did not have significant difference (p = 0.69) , While the value eGFR the two groups did not have significant differences with the Cockroft Gault is p = 0.884; MDRD p = 0.886; and CKDEP p = 0.490. Analysis of urinary hydrogen peroxide and eGFR based on the MDRD equation and CKDEPI generate significant positive correlation (r = 0.326; p = 0.021) and (r = 0.282; p = 0.047).
]"
2015
S61099
UI - Skripsi Membership  Universitas Indonesia Library
cover
Clarasintha Nindyatami
Analisis efektivitas-biaya terapi kombinasi metformin- akarbose dan metformin-sulfonilurea pada pasien diabetes mellitus tipe 2 di RSPAD Gatot Soebroto = Cost effectiveness analysis of metformin acarbose and metformin sulfonylurea combination therapy in diabetes mellitus type 2 patients in RSPAD Gatot Soebroto
"Diabetes mellitus tipe 2 merupakan penyakit dengan beban biaya tinggi dan dapat memberi efek negatif terhadap kualitas hidup penderitanya. Diabetes merupakan salah satu penyakit yang banyak dijumpai pada pasien RSPAD Gatot Soebroto. RSPAD Gatot Soebroto merupakan pemberi pelayanan kesehatan tingkat tiga yang menjadi rujukan tertinggi bagi Tentara Nasional Indonesia TNI Angkatan Darat dan masyarakat. Terapi diabetes mellitus tipe 2 memiliki beragam pola terapi kombinasi. Terapi yang beragam akan memberikan efektivitas dan biaya yang berbeda pula. Penelitian ini dilakukan terhadap dua jenis terapi kombinasi, yaitu metformin-akarbose dan metformin-sulfonilurea. Penelitian ini memberikan gambaran terapi kombinasi yang memiliki efektivitas-biaya lebih baik dalam segi tingkat pencapaian target HbA1C.
Diabetes mellitus type 2 is a high cost disease and has a negative effect on patients rsquo quality of life. Diabetes mellitus type 2 is one of the main diseases found in RSPAD Gatot Soebrotos outpatients. RSPAD Gatot Soebroto is a tertiary health care provider which is the highest medical care referral for the Indonesian Army and society. Diabetes mellitus type 2 therapy has various combination therapy patterns. Different therapy will give different effectiveness and cost result. This study was done for two combination therapies, metformin acarbose and metformin sulfonylurea. This study gives an insight on which combination therapy is more cost effective based on the target HbA1C."
Depok: Fakultas Farmasi Universitas Indonesia, 2018
S-Pdf
UI - Skripsi Membership  Universitas Indonesia Library
cover
Sylvia S
Effectiveness comparison between insulin, sulfonylurea and sulfonylurea-biguanide combination on HbA1C and e-GFR level of type 2 diabetes mellitus patiens at Dr. Sitanala Hospital (article on The 1st International Conference on Pharmacy education and research network of ASEAN)
2015
MK-Pdf
UI - Makalah dan Kertas Kerja  Universitas Indonesia Library
cover
Rizky Mutiara Mahani
Perbandingan kadar hidrogen peroksida urin dengan estimasi laju filtrasi glomerulus (eLFG) pada pasien diabetes melitus tipe 2 yang mengkonsumsi biguanid dan kombinasi biguanid-sulfonilurea = Ratio of urinary hydrogen peroxide with estimated GFR in type 2 diabetes melitus patients consuming biguanide and combination of biguanide sulfonylurea
"ABSTRAK
Stres oksidatif berperan dalam kerusakan fungsi ginjal pada pasien diabetes melitus tipe 2. Hingga saat ini belum ada penanda yang dapat mendeteksi kerusakan ginjal sejak awal. Penelitian ini bertujuan menganalisis kadar hidrogen peroksida pada urin sebagai penanda stres oksidatif dan mengungkap hubungan dengan estimasi laju filtrasi glomerulus sebagai parameter fungsi ginjal. Kadar hidrogen peroksida urin dan nilai eLFG juga dibandingkan antara dua kelompok pengobatan untuk mengetahui efektivitas pengobatan pada pasien diabetes melitus tipe 2. Desain penelitian yang digunakan adalah cross sectional dengan jumlah sampel keseluruhan sebanyak 84 orang. Pengambilan sampel dilakukan di puskesmas kecamatan Pasar Minggu. Nilai hidrogen peroksida urin diperoleh dengan pengukuran menggunakan metode Ferrous ion Oxidation Xylenol Orange 1 (FOX-1) dan dinormalisasi dengan nilai kreatinin urin. Pengukuran kreatinin urin dilakukan dengan metode kinetik Jaffe. Perhitungan nilai eLFG diperoleh dengan 3 tiga rumus yaitu Cockroft-gault, MDRD, dan CKD-EPI. Kadar hidrogen peroksida urinpada dua kelompok pengobatan tidak berbeda bermakna (p = 0,545. Hasil uji beda nilai eLFG pada dua kelompok juga tidak berbeda bermakna (Cockroft-Gault p = 0,677; MDRD p = 0,830; dan CKD-EPI p= 0,548). Hasil analisis hubungan kadar hidrogen peroksida urin dengan ketiga nilai eLFG tidak menunjukkan hubungan yang bermakna (Cockroft-Gault p = 0,900 ; MDRD p = 0,842; dan CKD-EPI p= 0,703).
ABSTRACT
Oxidative stress plays a major role in renal dysfunction caused by type 2 diabetes
melitus. Up to now, there is no biomarker can be used in early detection of renal dysfunction. This study aims to analyze of urinary hydrogen peroxide concentration as biomarker of oxidative stress and correlated it with estimated Glomerular Filtration Rate as parameters of renal function. Urinary hydrogen peroxide and value of eGFR were also compared between the two groups of treatment to find out the effectiveness of treatment in type 2 diabetic patients. Design of this study was cross sectional with 84 sample that was taken in Puskesmas Pasar Minggu. Concentration of urinary hydrogen peroxide were measured with Ferrous ion Oxidation Xylenol Orange 1 (FOX-1) method and normalize with urine creatinine that measured with kinetic Jaffe method. Three formulations used to measure value of eGFR were Cockroft-gault, MDRD, dan CKD-EPI. Concentration of urinary hydrogen peroxide in two groups of treatment have no significant difference (p = 0,545), while value of eGFR also didn?t have significant different (Cockroft-Gault p = 0,677; MDRD p = 0,830; dan CKD-EPI p= 0,548). Results of correlation analysis urinary hydrogen peroxide with eGFR showedno significant correlation (Cockroft-Gault p = 0,900 ; MDRD p = 0,842; dan CKD-EPI p= 0,703)."
2016
S64783
UI - Skripsi Membership  Universitas Indonesia Library
cover
Rahmaningtyas Nurifahmi
Analisis 8 iso prostaglandin f2a serta hubungannya dengan estimasi lfg pada pasien diabetes melitus tipe 2 yang mengkonsumsi sulfonilurea dan kombinasi biguanid sulfonilurea = Analysis of 8 iso prostaglandin f2a and its correlation with estimated gfr in type 2 diabetes mellitus patients consuming sulfonylurea and combination of biguanide sulfonylurea / Rahmaningtyas Nurifahmi
"ABSTRAK
Gangguan fungsi ginjal merupakan komplikasi yang sering terjadi pada pasien diabetes melitus tipe 2 yang dapat ditandai oleh senyawa 8-iso-Prostaglandin F2a. Pada penelitian ini, dilakukan analisis hubungan antara kadar 8-iso-Prostaglandin F2a dengan estimasi Laju Filtrasi Glomerulus (eLFG). Sampel yang dianalisis adalah 50 pasien diabetes melitus tipe 2 di RSK Dr. Sitanala Tangerang yang terbagi menjadi dua yaitu kelompok sulfonilurea dan kombinasi biguanid-sulfonilurea dengan teknik total sampling. Penelitian ini merupakan penelitian observasional dengan metode kohort retrospektif. Nilai eLFG diperoleh berdasarkan kadar kreatinin serum, sedangkan kadar 8-iso-Prostaglandin F2a diukur dengan metode Enzyme Linked Immunosorbent Assay (ELISA). Uji beda dilakukan terhadap nilai eLFG antara kedua kelompok, yaitu Cockroft Gault (p = 0,961), MDRD (p = 0,567), CKD-EPI (p = 0,443), serta pada kadar 8-iso-Prostaglandin F2a (p = 0,070). Hubungan antara kadar 8-iso-Prostaglandin F2α dengan nilai eLFG dianalisis pada seluruh sampel (n=48), yaitu Cockroft-Gault (r = 0,329; p = 0,023), MDRD (r = 0,231; p = 0,115) dan CKD-EPI (r = 0,256; p = 0,079). Sehingga, tidak terdapat perbedaan nilai eLFG dan kadar 8-iso-Prostaglandin F2a di antara kedua kelompok. Terdapat hubungan yang bermakna antara kadar 8-iso-Prostaglandin F2a dengan nilai eLFG berdasarkan Cockroft-Gault, namun tidak terdapat hubungan pada nilai eLFG MDRD dan CKD-EPI.
ABSTRACT
Renal dysfunction is a common complication in type 2 diabetes mellitus patient that can be characterized by 8-iso-prostaglandin F2a compound. The aim of this study was to analyze the correlation between the level of 8-iso-prostaglandin F2a and estimated Glomerular Filtration Rate (eGFR). Samples analyzed were 50 patients with type 2 diabetes mellitus in Dr. Sitanala Tangerang Hospital were divided into two groups of sulfonylurea and combination of biguanide-sulfonylurea using total sampling technique. This study was an observasional study using cohort retrospective method. The value of eGFR obtained by serum creatinine levels, while the level of 8-iso-Prostaglandin F2a measured by the method of Enzyme Linked Immunosorbent Assay (ELISA). Different test carried out on eGFR values ​​between the two groups, those were Cockroft-Gault (p = 0,961), MDRD (p = 0,567), CKD-EPI (p = 0,443), as well as on the level of 8-iso-prostaglandin F2a (p = 0.070). The correlation between the levels of 8-iso-prostaglandin F2a with eGFR was analyzed on all samples (n=48), those are Cockroft-Gault (r = 0,329; p = 0,023), MDRD (r = 0,231; p = 0,115) and CKD-EPI (r = 0,256; p = 0,079). Thus, there was no difference in eGFR values ​​and levels of 8-iso-Prostaglandin F2a between the two groups. There was significant correlation between the levels of 8-iso-Prostaglandin F2a and eGFR values were calculated by Cockroft-Gault equation, meanwhile there was no correlation in eGFR values were calculated by MDRD and CKD-EPI equation.
"
2015
S60238
UI - Skripsi Membership  Universitas Indonesia Library
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Raja Andriany
Analisis 8-iso-prostaglandin F2α . dan hubungannya dengan UACR pada pasien diabetes melitus tipe 2 yang mengkonsumsi biguanid dan kombinasi biguanid-sulfonilurea = Analysis of 8 iso prostaglandin F2α and its correlation with UACR on type 2 diabetes mellitus patients who consume biguanid and biguanid sulfonylurea combination
"ABSTRAK
Nefropati diabetika dapat dideteksi melalui nilai UACR. Di sisi lain, 8-iso-
Prostaglandin F2α sedang diteliti perannya sebagai penanda awal disfungsi ginjal.
Penelitian ini bertujuan untuk menganalisis kadar 8-iso-Prostaglandin F2α, UACR
serta hubungan 8-iso-Prostaglandin F2α dan UACR pada 72 orang pasien diabetes
melitus tipe 2 (usia 33-75 tahun) di Puskesmas Kecamatan Pasar Minggu. Sampel
penelitian dibagi menjadi 2 kelompok, yaitu kelompok biguanid (n = 36) dan
kelompok biguanid-sulfonilurea (n = 36). Kadar 8-iso-Prostaglandin F2α urin diukur
menggunakan ELISA dan albumin urin diukur menggunakan kit BCG Albumin.
Hasil uji beda rata-rata menunjukkan tidak terdapat perbedaan kadar 8-iso-
Prostaglandin F2α (p = 0,083) dan UACR (p = 0,509) pada kedua kelompok sampel.
Hasil uji beda rata-rata pada kelompok sampel dengan albuminuria (n = 33) juga
menunjukkan tidak terdapat perbedaan kadar 8-iso-Prostaglandin F2α (p = 0,532)
dan UACR (p = 0,067). Hubungan antara kadar 8-iso-Prostaglandin F2α dengan
UACR pada seluruh sampel (r = 0,120; p = 0,315), sedangkan antara 8-iso-
Prostaglandin F2α dengan UACR pada kelompok albuminuria (r = 0,534; p = 0,001).
Jadi, tidak terdapat hubungan yang signifikan antara kadar 8-iso-Prostaglandin F2α
dengan UACR pada seluruh sampel, tetapi terdapat hubungan yang cukup kuat dan
signifikan antara kadar 8-iso-Prostaglandin F2α dengan UACR pada sampel dengan
albuminuria.
ABSTRACT
Diabetic nephropathy can be detected by UACR value. Meanwhile, 8-iso-
Prostaglandin F2α is being studied for its role as early marker for renal dysfunction.
This study were to analize 8-iso-Prostaglandin F2α, UACR, and the correlation
between 8-iso-Prostaglandin F2α and UACR on 72 type 2 diabetes mellitus patient
(from ages: 33-75 years) at Pasar Minggu Community Health Center. Samples were
divided into two groups, which was biguanid group (n = 36) and biguanidsulfonylurea
group (n = 36). Urinary 8-iso-Prostaglandin F2α was measured by
ELISA and urinary albumin by BCG Albumin kit. The results of mean different test
showed there were no difference for 8-iso-Prostaglandin F2α (p=0,083) and UACR
(p=0,509) in two group samples. The results of mean different test showed there
were also no difference for 8-iso-Prostaglandin F2α (p=0,532) and UACR (p=0,067)
in group samples with albuminuria (n=33). The correlation between 8-iso-
Prostaglandin F2α and UACR on total samples (r = 0,120; p = 0,315), meanwhile
the correlation between 8-iso-Prostaglandin F2α with UACR on samples with
albuminuria (r = 0,534; p = 0,001). So, there was no significant correlation between
8-iso-Prostaglandin F2α and UACR on total samples, meanwhile there was strong
enough and significant correlation between 8-iso-Prostaglandin F2α and UACR on
samples with albuminuria."
2016
S64767
UI - Skripsi Membership  Universitas Indonesia Library
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Abu Rachman
Perbandingan Pengaruh Metformin Tunggal dengan Kombinasi Metformin-Sulfonilurea terhadap Fungsi Kognitif pada Pasien Diabetes Melitus Tipe 2 di Puskesmas Pasar Minggu = Comparison of the Effect of Metformin with Metformin-Sulfonylurea Combination on Cognitive Function in Type 2 Diabetes Mellitus Patients at Pasar Minggu Health Center
"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.
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."
Depok: Fakultas Farmasi Universitas Indonesia, 2023
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