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All Journal Ibnu Sina: Jurnal Kedokteran dan Kesehatan - Fakultas Kedokteran Universitas Islam Sumatera Utara Jurnal Penyakit Dalam Indonesia
Hardigaloeh, Amanda Trixie
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Humanities Health Professions Medicine & Pharmacology Public Health

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Penggunaan Continous Glucose Monitoring pada Pasien DM Tipe 2 dengan Insulin Dosis Tinggi Hardigaloeh, Amanda Trixie; Tahapary, Dicky; Yunir, Em; Juli Edi Tarigan, Tri
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Abstract

Type 2 diabetes mellitus (T2DM) is a chronic disease with a high risk of complications, requiring optimal glycemic control. This case report aims to describe the use of continuous glucose monitoring (CGM) in the evaluation of a patient with T2DM and obesity whose glycemic levels remained uncontrolled despite high-dose insulin therapy. A 58-year-old woman with an 18-year history of T2DM presented to the Endocrinology Clinic of Cipto Mangunkusumo Hospital with uncontrolled blood glucose accompanied by classic diabetic symptoms. CGM revealed that the majority of glucose levels were within the time above range (TAR) at 83% without hypoglycemia, while the time in range (TIR) was only 17%. Contributing factors included a high-carbohydrate diet, limited physical activity, and technical difficulties with insulin injection. Interventions consisted of dietary re-education, gradual physical activity, optimization of injection technique, and insulin dose adjustment. CGM provided a comprehensive glycemic profile and helped identify non-pharmacological factors hindering glycemic control. This case highlights the role of CGM as an essential tool for individualized therapy in patients with T2DM requiring high-dose insulin.
DETEKSI DINI GANGGUAN MINERAL TULANG PADA PENYAKIT GINJAL KRONIK: TINJAUAN SISTEMATIK: EARLY DETECTION OF BONE MINERAL DISORDERS IN CHRONIC KIDNEY DISEASE: A SYSTEMATIC REVIEW Agustiawan; Mukmin, Sugianto; Mastari, Ekawaty Suryani; Hardigaloeh, Amanda Trixie; Susanto, Denny
Ibnu Sina: Jurnal Kedokteran dan Kesehatan - Fakultas Kedokteran Universitas Islam Sumatera Utara Vol. 25 No. 1 (2026): Januari 2026
Publisher : Faculty of Medicine Universitas Islam Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30743/ibnusina.v25i1.1052

Abstract

Gangguan metabolisme mineral dan tulang merupakan komplikasi penting pada pasien penyakit ginjal kronik yang berdampak pada meningkatnya morbiditas, mortalitas, dan risiko fraktur tulang. Tinjauan sistematik ini bertujuan untuk menganalisis bukti terkini mengenai peran biomarker biokimia dan pemeriksaan radiologis dalam deteksi dini CKD-MBD pada pasien CKD stadium 2–5. Pencarian literatur dilakukan melalui PubMed, Scopus, dan ScienceDirect untuk periode 2015–2025. Empat studi yang memenuhi kriteria inklusi berasal dari India, Italia, Tiongkok, dan Bangladesh, dengan desain potong lintang dan kohort prospektif. Bukti yang kami himpun menunjukkan bahwa peningkatan kadar parathyroid hormone (PTH), fosfat, alkaline phosphatase (ALP), dan fibroblast growth factor-23 (FGF-23) secara konsisten berhubungan dengan penurunan bone mineral density (BMD) serta progresivitas CKD. Kombinasi pemeriksaan biokimia dengan densitometri tulang (DXA) dan pendekatan berbasis machine learning terbukti meningkatkan akurasi diagnosis dini. Oleh karena itu, pemantauan biomarker tersebut dapat menjadi strategi penting dalam deteksi dan pencegahan CKD-MBD secara komprehensif.
Co-Authors Agustiawan Andri Sanityoso Sulaiman Em Yunir, Em Irsan Hasan Juli Edi Tarigan, Tri Mastari, Ekawaty Suryani Mukmin, Sugianto Rino Alvani Gani Susanto, Denny Tahapary, Dicky