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Jan 29, 2023
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May 31, 2024
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Abstract
Tujuan Penelitian: Pada tahun 2016, DM tipe 2 dan komplikasinya bertanggung jawab atas 6% kematian di Indonesia. Komplikasi yang angka kejadiannya lebih tinggi adalah komplikasi makrovaskular. Penelitian ini dilakukan untuk mengetahui hubungan antara kadar HbA1c dengan kejadian komplikasi makrovaskular pada pasien DM tipe 2.
Metode: Penelitian ini merupakan penelitian analitik observasional dengan pendekatan potong lintang. Sampel penelitian adalah 182 pasien DM tipe 2 di RSPAL dr. Ramelan pada tahun 2020-2022 yang telah memenuhi kriteria inklusi dan ekslusi. Teknik pengambilan data adalah purposive sampling. Jenis data yang digunakan dalam penelitian ini adalah data sekunder berupa rekam medis. Data kemudian di analisis dengan menggunakan program komputer SPSS.
Hasil: Banyaknya komplikasi makrovaskular pada penderita DM tipe 2 adalah (73.1%) dengan komplikasi terbanyak adalah gangrene diabetik (48.1%), stroke (23.2%), PJK (15.8%), dan hipertensi (12.8%). Uji chi-square menunjukan hubungan yang signifikan antara kadar HbA1c signifikan dengan terjadinya komplikasi makrovaskular penderita DM tipe 2 (p=0.027). Uji koefisien kontingensi 0.162 menunjukan hubungan korelasi positif dan cukup lemah.
Kesimpulan: Secara statistik terdapat hubungan yang signifikan antara kadar HbA1c dengan terjadinya komplikasi makrovaskular pada penderita DM tipe 2.
Kata kunci : DM tipe 2; kadar HbA1c; komplikasi makrovaskular
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References
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[2] Bader, G.N., 2018. Influence of Iron Deficiency Anemia on HbA1c: A Review. Current Research in Diabetes & Obesity Journal, 5(3), pp.21–23. https://doi.org/10.19080/crdoj.2018.05.555665.
[3] Bots, S.H., Graaf, Y., Nathoe, H.M.W., Borst, G.J., Kappelle, J.L., Visseren, F.L.J., Westerink, J., Algra, A., van der Graaf, Y., Grobbee, D.E., Rutten, G.E.H.M., Visseren, F.L.J., de Borst, G.J., Kappelle, L.J., Leiner, T. and Doevendans, P.A., 2016. The influence of baseline risk on the relation between HbA1c and risk for new cardiovascular events and mortality in patients with type 2 diabetes and symptomatic cardiovascular disease. Cardiovascular Diabetology, 15(1), pp.1–8. https://doi.org/10.1186/s12933-016-0418-1.
[4] Farooque, U., Lohano, A.K., Hussain Rind, S., Rind, M.S., Karimi, S., Jaan, A., Yasmin, F. and Cheema, O., 2020. Correlation of Hemoglobin A1c With Wagner Classification in Patients With Diabetic Foot. Cureus, 6(7), pp.4–13. https://doi.org/10.7759/cureus.9199.
[5] Galicia-Garcia, U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K.B., Ostolaza, H. and Martín, C., 2020. Pathophysiology of type 2 diabetes mellitus. International Journal of Molecular Sciences, 21(17), pp.1–34. https://doi.org/10.3390/ijms21176275.
[6] Graves, L.E. and Donaghue, K.C., 2020. Vascular Complication in Adolescents With Diabetes Mellitus. Frontiers in Endocrinology, 11(June). https://doi.org/10.3389/fendo.2020.00370.
[7] Hanniya, R.M., Akbar, M.R. and Nurhayati, E., 2017. Hubungan kadar hba1c dengan komplikasi makrovaskular pada pasien diabetes mellitus tipe 2. Prosiding Pendidikan Dokter; Vol 3, No 1, Prosiding Pendidikan Dokter (Agustus, 2017); 46-52, [online] (2), pp.46–52. Available at:
[8] Hidayat, B., Ramadani, R.V., Rudijanto, A., Soewondo, P., Suastika, K. and Siu Ng, J.Y., 2022. Direct Medical Cost of Type 2 Diabetes Mellitus and Its Associated Complications in Indonesia. Value in Health Regional Issues, [online] 28, pp.82–89. https://doi.org/10.1016/j.vhri.2021.04.006.
[9] Hutabarat, U.M., Hasneli, Y. and Erwin, 2018. Hubungan Komplikasi Diabetes Mellitus Dengan Kualitas Hidup Pasien Diabetes Mellitus. Jurnal Keperawatan, 5(2), p.459.
[10] Imelda, S.I., 2019. Faktor-Faktor Yang Mempengaruhi Terjadinya diabetes Melitus di Puskesmas Harapan Raya Tahun 2018. Scientia Journal, 8(1), pp.28–39. https://doi.org/10.35141/scj.v8i1.406.
[11] International Diabetes Federation, 2017. Recommendations for Managing Type 2 diabetes in Primary Care. Diabetes Research and Clinical Practice.
[12] Katwal, P.C., Jirjees, S., Htun, Z.M., Aldawudi, I. and Khan, S., 2020. The Effect of Anemia and the Goal of Optimal HbA1c Control in Diabetes and Non-Diabetes. Cureus, 12(6), pp.1–9. https://doi.org/10.7759/cureus.8431.
[13] Kemenkes, 2020. Infodatin tetap produktif, cegah, dan atasi Diabetes Melitus 2020. Pusat Data dan Informasi Kementrian Kesehatan RI, .
[14] Khonsary, S., 2017. Guyton and Hall: Textbook of Medical Physiology. Surgical Neurology International, https://doi.org/10.4103/sni.sni_327_17.
[15] Kranenburg, G., Van Der Graaf, Y., Van Der Leeuw, J., Nathoe, H.M.W., De Borst, G.J., Kappelle, L.J., Visseren, F.L.J. and Westerink, J., 2015. The relation between HbA1c and cardiovascular events in patients with type 2 diabetes with and without vascular disease. Diabetes Care, 38(10), pp.1930–1936. https://doi.org/10.2337/dc15-0493.
[16] Lin, X., Xu, Y., Pan, X., Xu, J., Ding, Y., Sun, X., Song, X., Ren, Y. and Shan, P.F., 2020. Global, regional, and national burden and trend of diabetes in 195 countries and territories: an analysis from 1990 to 2025. Scientific Reports, [online] 10(1), pp.1–11. https://doi.org/10.1038/s41598-020-71908-9.
[17] Ong, C., 2022. Characteristic of Chronic Complications in Type 2 Diabetic Patient Based on Asian Perspective. Current Internal Medicine Research and Practice Surabaya Journal, 3(1), p.13. https://doi.org/10.20473/cimrj.v3i1.31412.
[18] Organisation, W.H., 2018. Global Report on Diabetes. Global Report on Diabetes, p.88.
[19] Parhusip, N.O., 2019. Komplikasi Makrovaskular Pada Penderita DM tipe 2. [online] Available at:
[20] PERKENI, 2020. Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 Dewasa di Indonesia 2015. (2015). PB PERKENI. Perkumpulan Endokrinologi Indonesia, [online] p.46. Available at:
[21] Primadina, M.A., 2015. the Effect of Menstrual Cycle To Blood Glucose Levels. Journal Majority, 4(3), pp.65–70.
[22] Shen, Y., Shi, L., Nauman, E., Katzmarzyk, P., Price-Haywood, E., Bazzano, A., Nigam, S. and Hu, G., 2020. Association between hemoglobin A1c and stroke risk in patients with type 2 diabetes. Journal of Stroke, 22(1), pp.87–98. https://doi.org/10.5853/jos.2019.01704.
[23] Sherwani, S.I., Khan, H.A., Ekhzaimy, A., Masood, A. and Sakharkar, M.K., 2016. Significance of HbA1c test in diagnosis and prognosis of diabetic patients. Biomarker Insights, 11, pp.95–104. https://doi.org/10.4137/Bmi.s38440.
[24] Shou, J., Chen, P.J. and Xiao, W.H., 2020. Mechanism of increased risk of insulin resistance in aging skeletal muscle. Diabetology and Metabolic Syndrome, [online] 12(1), pp.1–10. https://doi.org/10.1186/s13098-020-0523-x.
[25] Simbolon, D., Siregar, A. and Talib, R.A., 2020. Physiological factors and physical activity contribute to the incidence of type 2 diabetes mellitus in Indonesia. Kesmas, 15(3), pp.120–127. https://doi.org/10.21109/KESMAS.V15I3.3354.
[26] Timar, B. and Albai, O., 2013. The relationship between hemoglobin a1c and chronic complications in diabetes mellitus. Romanian Journal of Diabetes Nutrition and Metabolic Diseases, 19(2). https://doi.org/10.2478/v10255-012-0015-3.
[27] Webber, S., 2013. International Diabetes Federation. Diabetes Research and Clinical Practice, https://doi.org/10.1016/j.diabres.2013.10.013.