Profil Kontrol Glikemik Antidiabetik pada Pasien DM Tipe 2 dengan Sirosis Hati

https://doi.org/10.22146/jmpf.68075

Emy Oktaviani(1*), Lusi Indriani(2), Haryanti Wulandari(3)

(1) Program Studi Farmasi, Fakultas MIPA, Pakuan University, Bogor
(2) Program Studi Farmasi, Fakultas MIPA, Pakuan University, Bogor
(3) Program Studi Farmasi, Fakultas MIPA, Universitas Pakuan
(*) Corresponding Author

Abstract


Diabetes mellitus (DM) is a metabolic syndrome with multi-etiology characterized by chronic hyperglycemia. DM can cause a variety of complications, one of which is impaired liver function. The use of antidiabetics needs to get more attention because most antidiabetics are metabolized in the heart. This study aims to determine the control of antidiabetic glycemic, the relationship of antidiabetic types with effectiveness, as well as factors related to glycemic control in type 2 DM patients with liver cirrhosis.  This research was conducted in June-July at Fatmawati Central General Hospital with cross sectional design and data retrieval period of 2014-2019 conducted retrospectively. The observation parameters of glucose control in this study were current blood sugar (GDS). Of the 106 patients who met the inclusion criteria, it was seen that the use of insulin aspart single in 34 patients showed good glycemic control followed by the use of combination insulin glargine-aspart in 25 patients. The results of the Chi-square analysis showed that there was no significant relationship between the type of antidiabetic on glycemic control (p-value = 0,159). However, the results of the Chi-square test showed that there was a significant relationship between the severity of liver cirrhosis and glycemic control (p-value=0,021) and gender was another factor that also showed a significant relationship to glycemic control (p-value=0,042). The use of insulin aspart alone or in combination with insulin glargine is the best in controlling blood sugar levels while in T2DM patients with liver cirrhosis based on this study.


Keywords


Antidiabetik;Kontrol glikemik;Sirosis

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References

  1. Decroli Eva. Diabetes Mellitus Tipe 2. Pusat Penerbitan Bagian Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Andalas; 2019.
  2. WHO. Global Report on Diabetes. Published online 2016.
  3. IDF. Diabetes Atlas Eighth Edition. International Diabetes Federation; 2017.
  4. Mihardja L, Soetrisno U, Soegondo S. Prevalence and Clinical Profile of Diabetes Mellitus in Productive Aged Urban Indonesians. 2014;5(5):507-512. doi:10.1111/jdi.12177
  5. KEMENKES. Riset Kesehatan Dasar. Published online 2018.
  6. Kannan. Arshad. Kumar S. Asian Journal of Pharmaceutical and Clinical Research. A Study On Drug Utilization Of Oral Hypoglycemic Agents In Type-2 Diabetic Patients. 2011;4(4).
  7. Gangopadhyay K. Consensus Statement on Dose Modifications of Antidiabetic Agents in Patients with Hepatic Impairment. Published online 2017. doi:10.4103/ijem.IJEM
  8. García-Compeán D, González-González JA, Lavalle-González FJ, González-Moreno EI, Villarreal-Pérez JZ, Maldonado-Garza HJ. Current Concepts in Diabetes Mellitus and Chronic Liver Disease: Clinical Outcomes, Hepatitis C Virus Association, and Therapy. Digestive Diseases and Sciences. 2016;61(2):371-380. doi:10.1007/s10620-015-3907-2
  9. Chen HP, Shieh JJ, Chang CC, et al. Metformin decreases hepatocellular carcinoma risk in a dose-dependent manner: Population-based and in vitro studies. Gut. 2013;62(4):606-615. doi:10.1136/gutjnl-2011-301708
  10. Elkrief L, Rautou PE, Sarin S, Valla D, Paradis V, Moreau R. Diabetes mellitus in patients with cirrhosis: clinical implications and management. Liver International. 2016;36(7):936-948. doi:10.1111/liv.13115
  11. Elkrief L, Rautou PE, Sarin S, Valla D, Erie Paradis V, Moreau R. Diabetes mellitus in patients with cirrhosis: clinical implications and management. Published online 2016. doi:10.1111/liv.13115
  12. Al-Thuwaini TM, Al-Saadi AH, Natah TM, Wtwt AA, Al-Saadi K, Farhood HF. Study the levels of adiponectin, FSH, LH and Sex hormones in Type 2 diabetes (NIDDM) Experiment Findings · May 2013 CITATIONS 6 READS 197 Mitochondrial diversity View project Metabolic syndrome disturbances View project Study the levels of adiponectin, FSH, LH and Sex hormones in Type 2 diabetes (NIDDM). www.iiste.orgwww.iiste.org
  13. Natah TM, Wtwt MAA, Al-saadi HK, Al-saadi AH. Study the levels of adiponectin , FSH , LH and Sex hormones in Type 2 diabetes ( NIDDM ). 2013;3(2):172-182.
  14. DiPiro J, Schwinghammer T, DiPiro C WB. Pharmacotherapy Handbook Ninth Edition.; 2015.
  15. Kurniasari M. Evaluasi Interaksi Penggunaan Obat Hipoglikemik pada Pasien Rawat Inap di Bangsal Cempaka RSUD Panembahan Senopati Bantul Periode Agustus 2015 (disertasi). Fakultas Farmasi, Universitas Sanada Dharma. Yogyakarta. 2016;III(2).
  16. Holmes G, Galitz L, Hu P, Lyness W. British Journal of Clinical Pharmacology Pharmacokinetics of insulin aspart in obesity, renal impairment, or hepatic impairment. Br J Clin Pharmacol. 2005;60:5-469. doi:10.1111/j.1365-2125.2005.02476.x
  17. Haahr H, Heise T. Fast-Acting Insulin Aspart: A Review of its Pharmacokinetic and Pharmacodynamic Properties and the Clinical Consequences. Clinical Pharmacokinetics. 2020;59(2):155-172. doi:10.1007/s40262-019-00834-5
  18. Kupčová V, Arold G, Roepstorff C, Højbjerre M, Klim S, Haahr H. Insulin degludec: Pharmacokinetic properties in subjects with hepatic impairment. Clinical Drug Investigation. 2014;34(2):127-133. doi:10.1007/s40261-013-0154-1
  19. Wandira A, Amri AB, Umar H, Manggau MA. Pengaruh Terapi Terhadap Pasien Diabetes Melitus Tipe 2 Pre-Opperatif. Fakultas Farmasi Universitas Hasanuddin 2 Fakultas Kedokteran Universitas Hasanuddin (skripsi). Published online 2014.
  20. Tandon et al. Severe Muscle Depletion in Patients on the LiverTransplant Wait List: Its Prevalence andIndependent Prognostic Value. Liver Transplantation. 2012;13(5):767-768. doi:10.1002/lt
  21. ADA. Standards of Medical Care in diabetes. 2020;43.
  22. PERKENI. Pengelolaan Dan Pencegahan Diabetes Melitus Tipe 2 Di Indonesia 2015. 2015th ed. (PERKENI, ed.).; 2015.
  23. Dewantara A, Swastini D. Perbandingan Penggunaan Regular Human Insulin (RHI) Dan Insulin Aspart Terhadap Outcome Terapi Penyakit Diabetes Melitus Tipe 2 Dengan Komplikasi Hipertensi (Skripsi). Published online 2012.
  24. Deemer KS, Alvarez GF. A Rare Case of Persistent Lactic Acidosis in the ICU: Glycogenic Hepatopathy and Mauriac Syndrome. Case Reports in Critical Care 2016, 1-4 (2016). doi:10.1155/2016/6072909
  25. Hauri L, Faridah I. Kajian Efektivitas Penggunaan Obat Pada Pasien Diabetes Melitus Tipe 2 Di 3 Puskesmas Kota Yogyakarta. Fakultas Farmasi Universitas Ahmad Dahlan. Yogyakarta. Published online 2019:7.
  26. Chen YW, Chen HH, Wang TE, et al. The dissociation between the diabetes and both Child-Pugh score and in-hospital mortality in cirrhotic patients due to hepatitis B, hepatitis C, or alcoholic. Hepatology International. 2011;5(4):955-964. doi:10.1007/s12072-011-9274-y
  27. Pang Y, Kartsonaki C, Turnbull I, et al. Diabetes, Plasma Glucose, and Incidence of Fatty Liver, Cirrhosis, and Liver Cancer: A Prospective Study of 0.5 Million People. Hepatology. 2018;68(4). doi:10.1002/hep.30083/suppinfo
  28. Lauschke VM, Ingelman-Sundberg M. The importance of patient-specific factors for hepatic drug response and toxicity. International Journal of Molecular Sciences. 2016;17(10). doi:10.3390/ijms17101714
  29. Campesi I, Seghieri G, Franconi F. Type 2 diabetic women are not small type 2 diabetic men: Sex-and-gender differences in antidiabetic drugs. Current Opinion in Pharmacology. 2021;60:40-45. doi:10.1016/j.coph.2021.06.007



DOI: https://doi.org/10.22146/jmpf.68075

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