* Corresponding Author
FAKTOR PASIEN YANG MEMPENGARUHI RESPONGLIKEMIK PENGGUNAAN MONOTERAPI METFORMIN PADA DIABETES MELITUS TIPE 2
https://doi.org/10.22146/jmpf.355 Vitarani Dwi Ananda Ningrum(1*), Zullies Ikawati(2), Ahmad Hamim Sadewa(3), M. Robikhul Ikhsan(4), Yunilistiaingsih Yunilistiaingsih(5)
(1) Program Studi Farmasi, Universitas Islam Indonesia Fakultas Farmasi, Universitas Gadjah Mada
(2) Fakultas Farmasi, Universitas Gadjah Mada
(3) Fakultas Kedokteran, Universitas Gadjah Mada
(4) KSM Penyakit Dalam, RSUP Dr. Sardjito
(5) Instalasi Farmasi, Puskesmas Jetis Yogyakarta
(*) Corresponding Author
Abstract
Metformin sebagai obat antidiabetik oral terpilih pada terapi diabetes melitus tipe 2 (DMT2) menunjukkan ketidaktercapaian target glikemik pada 35 – 40% pasien. Penelitian ini bertujuan menganalisis faktor pasien yang berpengaruh terhadap respon glikemik penggunaan metformin tunggal pada pasien DMT2. Penelitian kohort prospektif dilakukan pada 5 Puskesmas periode Januari-Oktober 2015 dengan melibatkan pasien DMT2 dewasa tanpa riwayat disfungsi tiroid dan gagal hati kronik. Parameter respon glikemik menggunakan glukosa darah puasa (GDP) dan glycated albumin (GA). Sebanyak 35 pasien dengan rata-rata usia, indeks masa tubuh (IMT), serta eLFG masing-masing yaitu 50,48±6,67 tahun, 25,99±4,79 kg/m2, dan 96,49±18,17 mL/mnt terlibat dalam penelitian. Penelitian menunjukkan selain indeks glikemik awal, faktor demografi pasien tidak berkorelasi baik dengan nilai GDP, GA maupun perubahan nilai keduanya setelah penggunaan rutin monoterapi metformin. Sementara itu, lama terapi metformin sebelumnya mempengaruhi nilai GDP akhir dan perubahan nilai GDP (P<0,05), namun tidak dengan nilai GA setelah penggunaan monoterapi metformin. Penelitian ini merekomendasikan durasi penggunaan rutin metformin sebelumnya perlu dipertimbangkan untuk penentuan waktu pemantauan ketercapaian target glikemik penggunaan metformin dalam implikasinya terhadap penyesuaian besaran dosis pada pasien DMT2.
Keywords
Full Text:
PDF (Bahasa Indonesia)References
Ahmad, N.S., Islahudin, F., dan Paraidathathu, T., 2014. Factors associated with good glycemic control among patients with type 2 diabetes mellitus. Journal of Diabetes Investigation, 5: 563–569.
Al Balushi, K.A., Al-Haddabi, M., Al-Zakwani, I., dan Al Za’abi, M., 2014. Glycemic control among patients with type 2 diabetes at a primary health care center in Oman. Primary Care Diabetes, 8: 239–243.
American Pharmacist Association, 2012. Drug Information Handbook, 20th ed. Lexi-comp, Ohio, USA.
Bakris, G.L. dan Molitch, M.E., 2016. Should Restrictions Be Relaxed for Metformin Use in Chronic Kidney Disease? Yes, They Should Be Relaxed! What’s the Fuss? Diabetes Care, 39: 1287–1291.
Bulló, M., García-Lorda, P., Megias, I., dan Salas-Salvadó, J., 2003. Systemic inflammation, adipose tissue tumor necrosis factor, and leptin expression. Obesity Research, 11: 525–531.
Dalan, R., Earnest, A., dan Leow, M., 2013. Ethnic Variation in the Correlation Between Fasting Glucose Concentration and Glycated Hemoglobin (HbA1c). Endocrine Practice, 19: 812–817.
DiStefano, J.K. dan Watanabe, R.M., 2010. Pharmacogenetics of Anti-Diabetes Drugs. Pharmaceuticals, 3: 2610–2646.
Don, B.R. dan Kaysen, G., 2004. Serum albumin: relationship to inflammation and nutrition. Seminars in Dialysis, 17: 432–437.
Donnelly, L.A., Doney, A.S.F., Hattersley, A.T., Morris, A.D., dan Pearson, E.R., 2006. The effect of obesity on glycaemic response to metformin or sulphonylureas in Type 2 diabetes. Diabetic Medicine: A Journal of the British Diabetic Association, 23: 128–133.
Freedman, B.I., Shihabi, Z.K., Andries, L., Cardona, C.Y., Peacock, T.P., Byers, J.R., et al.,., 2010. Relationship between assays of glycemia in diabetic subjects with advanced chronic kidney disease. American Journal of Nephrology, 31: 375–379.
Funakoshi, S., Fujimoto, S., Hamasaki, A., Fujiwara, H., Fujita, Y., Ikeda, K., et al.,., 2008. Analysis of factors influencing pancreatic β-cell function in Japanese patients with type 2 diabetes: Association with body mass index and duration of diabetic exposure. Diabetes Research and Clinical Practice, 82: 353–358.
Furusyo, N., Koga, T., Ai, M., Otokozawa, S., Kohzuma, T., Ikezaki, H., et al.,., 2011. Utility of glycated albumin for the diagnosis of diabetes mellitus in a Japanese population study: results from the Kyushu and Okinawa Population Study (KOPS). Diabetologia, 54: 3028–3036.
Garber, A.J., Duncan, T.G., Goodman, A.M., Mills, D.J., dan Rohlf, J.L., 1997. Efficacy of Metformin in Type II Diabetes. The American Journal of Medicine, 103: 491–497.
Golay, A., 2007. Metformin and body weight. International Journal of Obesity, 32: 61–72.
Huh, J.H., Kim, K.J., Lee, B.-W., Kim, D.W., Kang, E.S., Cha, B.S., et al.,., 2014. The Relationship between BMI and Glycated Albumin to Glycated Hemoglobin (GA/A1c) Ratio According to Glucose Tolerance Status. PLOS ONE, 9: e89478.
IndonesianAssociation of Endocrinologists (Perkeni), 2011. Consensus on Type-2 Diabetes Mellitus: Control and Prevention.
Ito, H., Ishida, H., Takeuchi, Y., Antoku, S., Abe, M., Mifune, M., et al.,., 2010. Long-term effect of metformin on blood glucose control in non-obese patients with type 2 diabetes mellitus. Nutrition & Metabolism, 7: 83.
Ji, L., Li, H., Guo, X., Li, Y., Hu, R., dan Zhu, Z., 2013. Impact of Baseline BMI on Glycemic Control and Weight Change with Metformin Monotherapy in Chinese Type 2 Diabetes Patients: Phase IV Open-Label Trial. PLoS ONE, 8: .
Kassahun, A., Gashe, F., Mulisa, E., dan Rike, W.A., 2016. Nonadherence and factors affecting adherence of diabetic patients to anti-diabetic medication in Assela General Hospital, Oromia Region, Ethiopia. Journal of Pharmacy & Bioallied Sciences, 8: 124–129.
Kemenkes RI, 2013. Riset Kesehatan Dasar 2013.
Kim, K.J. dan Lee, B.-W., 2012. The Roles of Glycated Albumin as Intermediate Glycation Index and Pathogenic Protein. Diabetes & Metabolism Journal, 36: 98–107.
Koga, M., Hirata, T., Kasayama, S., Ishizaka, Y., dan Yamakado, M., 2015. Body mass index negatively regulates glycated albumin through insulin secretion in patients with type 2 diabetes mellitus. Clinica Chimica Acta; International Journal of Clinical Chemistry, 438: 19–23.
Koga, M. dan Kasayama, S., 2010. Clinical impact of glycated albumin as another glycemic control marker. Endocrine Journal, 57: 751–762.
Koga, M., Murai, J., Saito, H., Matsumoto, S., dan Kasayama, S., 2009. Effects of thyroid hormone on serum glycated albumin levels: Study on non-diabetic subjects. Diabetes Research and Clinical Practice, 84: 163–167.
Koga, M., Otsuki, M., Matsumoto, S., Saito, H., Mukai, M., dan Kasayama, S., 2007. Negative association of obesity and its related chronic inflammation with serum glycated albumin but not glycated hemoglobin levels. Clinica Chimica Acta, 378: 48–52.
Lee, E.Y., Lee, B.-W., Kim, D., Lee, Y., Kim, K.J., Kang, E.S., et al.,., 2011. Glycated albumin is a useful glycation index for monitoring fluctuating and poorly controlled type 2 diabetic patients. Acta Diabetologica, 48: 167–172.
Lee, W.Y., Kwon, C.H., Rhee, E.J., Park, J.B., Kim, Y.K., Woo, S.Y., et al.,., 2011. The effect of body mass index and fasting glucose on the relationship between blood pressure and incident diabetes mellitus: a 5-year follow-up study. Hypertension Research, 34: 1093–1097.
Levey, A.S., Stevens, L.A., Schmid, C.H., Zhang, Y. (Lucy), Castro, A.F., Feldman, H.I., et al.,., 2009. A New Equation to Estimate Glomerular Filtration Rate. Annals of internal medicine, 150: 604–612.
Malin, S.K. dan Kashyap, S.R., 2014. Effects of metformin on weight loss: potential mechanisms. Current Opinion in Endocrinology, Diabetes, and Obesity, 21: 323–329.
Ong, C.R., Molyneaux, L.M., Constantino, M.I., Twigg, S.M., dan Yue, D.K., 2006. Long-Term Efficacy of Metformin Therapy in Nonobese Individuals With Type 2 Diabetes. Diabetes Care, 29: 2361–2364.
Reinehr, T., Kiess, W., Kapellen, T., dan Andler, W., 2004. Insulin sensitivity among obese children and adolescents, according to degree of weight loss. Pediatrics, 114: 1569–1573.
Rojas, L.B.A. dan Gomes, M.B., 2013. Metformin: an old but still the best treatment for type 2 diabetes. Diabetology & Metabolic Syndrome, 5: 6.
Roohk, H.V. dan Zaidi, A.R., 2008. A Review of Glycated Albumin as an Intermediate Glycation Index for Controlling Diabetes. Journal of diabetes science and technology (Online), 2: 1114–1121.
Sapkota, S., Brien, J., Greenfield, J., dan Aslani, P., 2015. A Systematic Review of Interventions Addressing Adherence to Anti-Diabetic Medications in Patients with Type 2 Diabetes—Impact on Adherence. PLoS ONE, 10: .
Won, H.K., Kim, K.J., Lee, B.-W., Kang, E.S., Cha, B.S., dan Lee, H.C., 2012. Reduction in glycated albumin can predict change in HbA1c: comparison of oral hypoglycaemic agent and insulin treatments. Diabetic Medicine: A Journal of the British Diabetic Association, 29: 74–79.
Wu, W.-C., Ma, W.-Y., Wei, J.-N., Yu, T.-Y., Lin, M.-S., Shih, S.-R., et al.,., 2016. Serum Glycated Albumin to Guide the Diagnosis of Diabetes Mellitus. PLOS ONE, 11: e0146780.
DOI: https://doi.org/10.22146/jmpf.355
Article Metrics
Abstract views : 1923
| 
views : 7618
Refbacks
- There are currently no refbacks.
Copyright (c) 2016 JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
