Analisis Korelasi Gula Darah Puasa, HbA1c, dan Karakteristik Partisipan

https://doi.org/10.22146/jmpf.62292

Nidaul Hasanah(1*), Zullies Ikawati, Apt.(2)

(1) Graduate Program of Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta
(2) Department of Pharmacology, Faculty of Pharmacy, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Hemoglobin A1c (HbA1c) measurement is recommended as the gold standard in long-term blood sugar monitoring the diabetes patients because the fasting blood sugar (FBG) pattern alone cannot provide accurate information regarding the blood sugar variability true picture in type 2 Diabetes mellitus (T2DM) patients. However, many patients have limited access to HbA1c testing for financial reasons. It is necessary to know the relationship between HbA1c and GDP, and the factors that influence it, especially the research participant characteristics. This analytic observational study with a cross-sectional design involved 100 participants from T2DM patients in the hospital, outpatient clinics, and communities in Yogyakarta Province from January-May 2020. The HbA1c and FPG measurement was carried out using capillary blood samples by the research team. Characteristic data were obtained through direct interviews with participants, then analyzed using SPSS version 25 for windows, using the chi-square, Kolmogorov-Smirnov, and Spearman's rho test. The results showed that FPG was significantly positively correlated with HbA1c with moderate correlation criteria (r=0.74, P-value<0.0001). FPG showed a significant negative correlation to the glucometer ownership variable (r=-0.22, P-value= 0.04), and was independent of other parameters. Meanwhile, HbA1c significantly negatively correlated with age (r=-0.26, P-value=0.01), education level (r=-0.22, P-value=0.04), comorbidity (r=-0, 24, P-value=0.02), routine drug consumption (r=-0.29, P-value=0.01) and the ownership of glucometer (r=-0.26, P-value=0.01), but independent of gender, smoking status, daily menu, and physical exercise. It can be concluded that both GDP and HbA1c can be used as a reference for assessing glycemic status.


Keywords


HbA1c; korelasi; gula darah puasa; karakteristik responden

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References

  1. PERKENI, Konsensus: Pengelolaan Dan Pencegahan Diabetes Mellitus Tipe-2 Di Indonesia, ed. by PERKENIPB. PERKENI. 2015.
  2. Kementerian Kesehatan Republik Indonesia. Riskesdas 2018 Dalam Angka : Laporan Nasional Riskesdas 2018. 2018).
  3. American Diabetes Association. 6. Glycemic Targets: Standards of Medical Care in Diabetes -2020, Diabetes Care. 2020; 43(Suppl. 1). S66-S67.
  4. Grant PJ Cosentino F, Aboyans V, et al. 2019 Esc Guidelines on Diabetes, Pre-Diabetes, and Cardiovascular Diseases Developed in Collaboration with the Easd: The Task Force for Diabetes, Pre-Diabetes, and Cardiovascular Diseases of the European Society of Cardiology (Esc) and the European Association for the Study of Diabetes (Easd), European Heart Journal. 2020; 41(2). 255-323. doi: 10.1093/eurheartj/ehz486
  5. Joanne Slavin Jennifer Erickson. Total, Added, and Free Sugars: Are Restrictive Guidelines Science-Based or Achievable?, Nutrients. 2015; 7(4). 2866-78. doi: 10.3390/nu7042866
  6. Murtiwi S. Tjokroprawiro A, Buku Ajar Ilmu Penyakit Dalam. Ed. 2: Fakultas Kedokteran Universitas Airlangga Rumah Sakit Pendidikan Dr. Soetomo Surabaya. 2 edn (Surabaya: Airlangga University Press, 2015).
  7. Ratnasari Nur Isnaini. Faktor Risiko Mempengaruhi Kejadian Diabetes Mellitus Tipe Dua, Jurnal Keperawatan dan Kebidanan Aisyiyah. 2018; 14(1). 59-68. doi: 10.31101/jkk.550
  8. Per-Anders Tengland. Behavior Change or Empowerment: On the Ethics of Health - Promotion Goals, Health Care Anal. 2016; 24(1). 24-46. doi: 10.1007/s10728-013-0265-0
  9. Hendrikus Nara Kwureh Abil Rudi. Faktor Risiko Yang Mempengaruhi Kadar Gula Darah Puasa Pada Pengguna Layanan Laboratorium, Wawasan Kesehatan. 2017; 3(2). 33-39.
  10. Susan Manley Stephen Gough, Irene Stratton, Hba1c in Diabetes: Case Studies Using Ifcc Units. 2010.
  11. Republika, Pemeriksaan Rutin Hba1c Pada Diabetesi, Republika, 2019 <https://www.republika.id/posts/1986/pemeriksaan-rutin-hba1c-pada-diabetesi> [Accessed 1 Desember 2020].
  12. Supri Hartini. Hubungan Hba1c Terhadap Kadar Glukosa Darah Pada Penderita Diabetes Mellitus Di Rsud Abdul Wahab Syahranie Samarinda, Husada Mahakam: Jurnal Kesehatan. 2017; 4(3).
  13. Charisma AM. Korelasi Kadar Rata-Rata Glukosa Darah Puasa Dan 2 Jam Post Prondial Tiga Bulan Terakhir Dengan Nilai Hba1c Pada Pasien Diabetes Melitus Prolanis Bpjs Kabupaten Kediri Periode Mei - Agustus 2017, J. Kesehat. Masy. Indones. 2017; 12(2). 1-11.
  14. Wungouw H Utomo MRS, Marunduh S. Kadar Hba1c Pada Pasien Diabetes Melitus Tipe 2 Di Puskesmas Bahu Kecamatan Malalayang Kota Manado, Journal e-Biomedik (eBm). 2015; 3(1).
  15. Dahlan MS, Statistik Untuk Kedokteran Dan Kesehatan (Jakarta: Salemba Medika, 2016).
  16. Josephine M. Egan Rita Rastogi Kalyani. Diabetes and Altered Glucose Metabolism with Aging, Endocrinol Metab Clin North Am. 2013; 42(2). 333-47. doi: 10.1016/j.ecl.2013.02.010
  17. Molly Babu Jeeva S. Knowledge of Diabetic Clients Regarding Self-Care Practices in Management of Type-Ii Diabetes Mellitus at Selected Rural Community of Bangalore, Karnataka, Asian J. Nursing Edu. and Research. 2017; 7(1). 86-94. doi: http://dx.doi.org/10.5958/2349-2996.2017.00018.0
  18. Dedy Irawan, 'Prevalensi Dan Faktor Risiko Kejadian Diabetes Melitus Tipe 2 Di Daerah Urban Indonesia (Analisa Data Sekunder Riskesdas 2007)', Universitas Indonesia, 2010).
  19. Jana V van Vliet-Ostaptchouk Sandra N Slagter, Judith M Vonk, H Marike Boezen, Robin PF Dullaart, Anneke C Muller Kobold, Edith J Feskens, André P van Beek, Melanie M van derKlauw & Bruce HR Wolffenbuttel. Association between Smoking, Components of Metabolic Syndrome and Lipoprotein Particle Size, BMC Medicine. 2013; 11). doi: https://doi.org/10.1186/1741-7015-11-195
  20. Hiroshi Yatsuya Esayas Haregot Hilawe, Yuanying Li, Mayu Uemura, Chaochen Wang, Chifa Chiang, Hideaki Toyoshima, Koji Tamakoshi, Yan Zhang, Nobuo Kawazoe, Atsuko Aoyama. Smoking and Diabetes: Is the Association Mediated by Adiponectin, Leptin, or C-Reactive Protein?, Journal of Epidemiology. 2015; 25(2). 99-109. doi: 10.2188/jea.JE20140055
  21. M-D Beaulieu J. Houle, J-L Chiasson, F Lesperance, J Cote, I Strychar, L Bherer, S Meunier, J Lambert. Glycaemic Control and Self-Management Behaviours in Type-2 Diabetes: Result from a 1-Year Longitudinal Cohort Study, Diabet. Med. 2015; 32(9). 1247-54. doi: doi: 10.1111/dme.12686
  22. Marion J. Franz, et al. Lifestyle Weight-Loss Intervention Outcomes in Overweight and Obese Adults with Type-2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Clinical Trials, Journal of The Academy of Nutritiion and Dietitics. 2015; 115(9). 1447-63.
  23. Bloomgarden ZT Handelsman Y, Grunberger G, et al. American Association of Clinical Endocrinologists and American College of Endocrinology - Clinical Practice Guidelines for Developing a Diabetes Mellitus Comprehensive Care Plan - 2015, Endocr Pract. 2015; 21(Suppl. 1). 1-87. doi: 10.4158/EP15672.GL.
  24. Garber AJ Garvey WT, Mechanick JI, et al. The American Association of Clinical Endocrinologists and the American College of Endocrinology Position Statement on the 2014 Advanced Framework for a New Diagnoses of Obesity as a Chronic Disease, Endocr Pract. 2014; 20(9). 977-89. doi: 10.4158/EP14280.PS
  25. Handelsman Y Garber AJ, Grunberger G, et al. Consensus Statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the Comprehensive Type 2 Diabetes Management Algorithm - 2020 Executive Summary Endocr Pract. 2020; 26(1). 107-39. doi: 10.4158/CS-2019-0472
  26. Etta J. Vinik Aaron I. Vinik, Sheri R. Colberg. Fall Risk in Older Adults with Type 2 Diabetes, Clin Geriatr Med. 2015; 31(1). 89-99. doi: 10.1016/j.cger.2014.09.002
  27. I Nyoman Sujaya, 'Pola Konsumsi Makanan Tradisional Bali Sebagai Faktor Risiko Kejadian Diabetes Melitus Tipe 2 Di Kabupaten Tabanan', Universitas Gadjah Mada, 2008).
  28. Soedijono Setyorogo Shara Kurnia Trisnawati. Faktor Risiko Kejadian Diabetes Melitus Tipe Ii Di Puskesmas Kecamatan Cengkareng Jakarta Barat Tahun 2012, Jurnal Ilmiah Kesehatan. 2013; 5(1).
  29. PERKENI, Pedoman Pemantauan Glukosa Darah Mandiri 2019, PB Perkeni. 2019.
  30. Peter Calhoun Sarah Puhr, John B. Welsh, and Tomas C. Walker. The Effect of Reduced Self-Monitored Blood Glucose Testing after Adoption of Continuous Glucose Monitoring on Hemoglobin A1c and Time in Range, Diabetes Technology & Therapeutics. 2018; 20(2). doi: 10.1089/dia.2018.0134
  31. Simon D Soulimane S, Herman WH, et al. Hba1c Fasting and 2-Hour Plasma Glucose in Current-, Ex-, and Non-Smoker; a Meta-Analysis, Diabetologia. 2014; 57(1). 30-39. doi: 10.1007/s001235-013-3058-y
  32. Huandong Lin Li Wu, Jian Gao, Xiaoming Li, Mingfeng Xia, Dan Wang, Qiqige Aleteng, Hui Ma, Baishen Pan, Xin Gao. Effect of Age on the Diagnostic Efficiency of Hba1c for Diabetes in a Chinese Middle-Aged and Elderly Population: The Shanghai Changfeng Study, PLoS One. 2017; 12(9). doi: 10.1371/journal.pone.0184607
  33. A Bhansali P Ravikumar 1, R Walia, G Shanmugasundar, M Ravikiran. Alterations in Hba(1c) with Advancing Age in Subjects with Normal Glucose Tolerance: Chandigarh Urban Diabetes Study (Cuds), Diabet. Med. 2011; 28(5). 590-4. doi: 10.1111/j.1464-5491.2011.03242.x.
  34. W. Xue N. Dubowitz, Q. Long, J. G. Ownby, D. E. Olson, D. Barb, M. K. Rhee, A. V. Mohan, P. I. Watson-Williams, S. L. Jackson, A. M. Tomolo, T. M. Johnson II, and L. S. Phillips. Aging Is Associated with Increased Hba1c Levels, Independently of Glucose Levels and Insulin Resistance, and Also with Decreased Hba1c Diagnostic Specificity, Diabetic Medicine. 2014; 31(8). 927-35. doi: 10.1111/dme.12459
  35. Acivrida Mega Charisma. Korelasi Kadar Rata-Rata Glukosa Darah Puasa Dan 2 Jam Post Prondial Tiga Bulan Terakhir Dengan Nilai Hba1c Pada Pasien Diabetes Mellitus Prolanis Bpjs Kabupaten Kediri Periode Mei-Agustus 2017, J. Kesehat. Masy. Indones. 2017; 12(2).
  36. L. Spanou K. Makris, A. Rambaouni-Antonelit, K. Koniari, I. Drakopoulos, D. Rizos and A. Haliassos. Relationship between Mean Blood Glucose and Glycated Haemoglobin in Type-2 Diabetes Patients, Diabet. Med. 2008; 25). 174-78. doi: 10.1111.j.1464-5491.2007.02379.x
  37. K. Akhuemokhan Andrew Edo. Relationship between Hemoglobin A1c and Spot Glucose Measurements in Nigerians with Type-2 Diabetes Mellitus, Nigerian Journal of Clinical Practice. 2012; 15(1). 23-6.
  38. Huang J Karnchanasorn R, Ou HY, et al. Comparison of the Current Diagnostic Criterion of Hba1c with Fasting and 2-Hour Plasma Glucose Concentration, Journal of Diabetes Research. 2016; 2016). doi: 10.1155/2016/6195494
  39. Vicki S. Freeman. Glucose and Hemoglobin A1c, Lab Medicine. 2014; 45(1). e21-e24. doi: 10.1309/LMNSU432YJWCWZKX
  40. Konstantinos Makris and Loukia Spanou. Is There a Relationship between Mean Blood Glucose and Glycated Hemoglobin?, Journal of diabetes Sciences and Technology. 2011; 5(6). 1572-83. doi: 10.1177/193229681100500634
  41. Bongaerts B Rathmann W, Kostev K. Association of Characteristics of People with Type 2 Diabetes with Discordant Values of Fasting Glucose and Hba1c, J Diabetes 2018; 10(12). 934-41. doi: doi: 10.1111/1753-0407.12823
  42. Sherman A Roy S, Monari-Sparks MJ, et al. Association of Comorbid and Metabolic Factors with Optimal Control of Type 2 Diabetes Mellitus, N Am J Med Sci. 2016; 8(1). 31-9. doi: doi: 10.4103/1947-2714.175197
  43. Dewi Prasetyani. Analisis Faktor-Faktor Yang Mempengaruhi Penurunan Kadar Gula Darah Pada Diabetesi Tipe-2 Jurnal Kesehatan Al-Irsyad (JKA). 2017; X(1). 24-29.
  44. Nadatein I Anggraini R, Astuti P. Relationship of Hba1c with Fasting Blood Glucose on Diagnostic Values and Lifestyle in Type Ii Diabetes Mellitus Patients, Journal of Medical Laboratory Science Technology. 2020; 3(1). 5-11. doi: doi: 10.21070/medicra.v3i1.651
  45. Jumaah IAM. Comparison between Fasting Plasma Glucose and Hba1c in Glycemic Control of Type-2 Diabetic Patients, Academic Scientific Journals. 2016; 24(9). 2633-44. doi: doi: 10.4158/EP.12.S1.42
  46. Sari N Sari MI, Darlan DM, Prasetya RJ. Cigarette Smoking and Hyperglycaemia in Diabetic Patients, Open Access Macedonian Journal of Medical Sciences. 2018; 6(4). 634-37. doi: https://doi.org/10.3889/oamjms.2018.140
  47. da Rosa VC Antonio JP, Sarmento RA, de Almeida JC. Diet Quality and Therapeutic Targets in Patients with Type 2 Diabetes: Evaluation of Concordance between Dietary Indexes, Nutr J. 2017; 16(1). 74. doi: doi: 10.1186/s12937-017-0296-8
  48. Wang PW Huang IC, Liu RT, et al. The Influence of Self-Monitoring Blood Glucose Frequency on the Oscillation of Hemoglobin A1c and Chronic Complications, Chang Gung Med J. 2012; 35(1). 45-53. doi: doi: 10.4103/2319-4170.106167
  49. Isaksen JL Ghouse J, Skov MW, et al. Effect of Diabetes Duration on the Relationship between Glycaemic Control and Risk of Death in Older Adults with Type 2 Diabetes, Diabetes Obes Metab. 2020; 22(2). 231-42. doi: doi: 10.1111/dom.13891
  50. Klausmann G Schnell O, Gutschek B, Garcia-Verdugo RM, Hummel M. Impact on Diabetes Self-Management and Glycemic Control of a New Color-Based Smbg Meter, J Diabetes Sci Technol. 2017; 11(6). 1218-25. doi: doi: 10.1177/1932296817706376
  51. Ima Nadatein Rahayu Anggraini, Puji Astuti. Relationship of Hba1c with Fasting Blood Glucose on Diagnostic Values and Lifestyle in Type Ii Diabetes Mellitus Patients, Journal of Medical Laboratory Science/Technology. 2020; 3(1). doi: https://doi.org/10.21070/medicra.v3i1.651
  52. Brenda Bongaerts Wolfgang Rathmann, Karel Kostev. Association of Characteristics of People with Type 2 Diabetes Mellitus with Discordant Values of Fasting Glucose and Hba1c, Diabetes. 2018; 10(12). 934-41. doi: 10.1111/1753-0407.12823
  53. Hang Xue John Kam-On Chung, Eric Wing-Hang Pang, Daniel Chuen-Chu Tam. Accuracy of Fasting Plasma Glucose and Hemoglobin A1c Testing for the Early Detection of Diabetes: A Pilot Study, Frontiers in Laboratory Medicine. 2017; 1(2). 76-81. doi: 10.1016/j.flm.2017.06.002
  54. Sacks MB David B, et al. A1c Versus Glucose Testing: A Comparison, Diabetes Care. 2011; 34(2). 518-23. doi: 10.2337/dc10-1546
  55. Zachary T Bloomgarden Anoop Misra. Discordance between Hba1c and Glycemia, Journal of Diabetes. 2018; 10). 908-10. doi: 10.1111/1753-0407.12843



DOI: https://doi.org/10.22146/jmpf.62292

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