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All Journal Narra J Jurnal Penyakit Dalam Indonesia
Tahapary, Dicky L.
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Peripheral Arterial disease and Cardiovascular Mortality in Type-2 Diabetes Mellitus Esa, Dekta Filantropi; Prahasary, Adelia Nova; Tahapary, Dicky L.; Yunir, Em
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 2
Publisher : UI Scholars Hub

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Peripheral arterial disease (PAD) is one of the macrovascular complications of type 2 diabetes mellitus (T2DM), which increases the risk of cardiovascular mortality. Ankle-brachial index (ABI) is one of the simple and widely available tool to diagnose PAD. The authors aim to find out the cardiovascular mortality in T2DM patient with PAD. Bundo et al. study found HR 2.45 (95% CI: 0.84 to 7.17). Mostaza et al. study reported HR 1.64 (95% CI: 0.64 to 4.49). Aboyans et al. study declared HR 2.21 (95% CI: 1.16 to 4.22). Mohammedi K et al. claimed HR 1.35 (95% CI: 1.15 to 1.60). Quiles et al. found HR 6.61 (95% CI: 2.47 to 17.72). Mueller et al. study reported RR 3,53 (95% CI: 1.80 to 6.91). Mueller et al. study reported RR 4,06 ( 95% CI: 2.67 to 6.18). In conclusion, the mortality risk in T2DM patients with PAD is higher compared to those without PAD. Moreover, an ankle-brachial index can be used as an independent stratification tool to predict the risk of cardiovascular mortality
The Selection of Oral Antidiabetic Drugs in Type 2 Diabetes Mellitus Patients with High Risk for Cardiovascular Events Leander, Derlin J.; Tahapary, Dicky L.
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 4
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Type 2 diabetes mellitus (DMT2) patients are associated with an increased risk of cardiovascular events. Prior to the era of cardio-vascular trial outcome (CVOT) evidence on the efficacy of old oral diabetes (OAD) drugs such as metformin, sulfonylurea, thiazolidindion, glinid, and alpha glucosidase inhibitors in reducing the risk of cardiovascular events was very limited. Since 2008, all OADs must have CVOT data. DPP-4 inhibitors are neutral against the risk of cardiovascular events while SGLT-2 inhibitors are reported to significantly reduce the risk of cardiovascular events. This finding even helped to change the DMT2 management guidelines issued by American Diabetes Association (ADA-EASD) in late 2018. However, SGLT-2 inhibitor applications in Indonesia are likely to be constrained in terms of costs. When compared with an intensive multifactorial approach that seeks to reduce blood glucose, lipids, blood pressure, weight, and aspirin; it turns out that this multifactorial approach is associated with a lower risk of higher cardiovascular events and lower costs. In the JKN era, where quality control and cost control are needed, it seems that the multifactorial approach will still be the main choice in reducing cardiovascular events in people with T2DM in Indonesia.
Efficacy and Safety of Oral Antidiabetic Drugs in Type 2 Diabetes Mellitus with Chronic Kidney Disease Sihotang, Retta C.; Ramadhani, Rizka; Tahapary, Dicky L.
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 3
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Herpes Zooster Induced Diabetic Ketoacidosis Suwita, Christopher Surya; Johan, Michael; Tahapary, Dicky L.; Darmowidjojo, Budiman
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 4
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Diabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes which is common in daily practice. DKA is the result of severe insulin deficiency and often presents as the first symptom of an undiagnosed diabetes even though it may also appear in individuals with diabetes. Some conditions that can trigger DKA include infections, myocardial infarction, stroke, pancreatitis, trauma, or poor treatment compliance. Skin tissue infections such as herpes zoster are rare inciting factor in DKA. This article will discuss a case of DKA that is triggered by herpes zoster.
Analysis of specialist doctors' behavior towards SGLT2 inhibitors prescription in Indonesia: A qualitative study Cokro, Fonny; Sauriasari, Rani; Tahapary, Dicky L.; Setiawan, Heri; Martha, Evi
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.2089

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Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have a broad range of clinical indications and are recommended by various guidelines for the management of diabetes, heart failure, and chronic kidney disease. However, prescribing rates for these agents are suboptimal towards various intended indications in many countries, including Indonesia. The aim of this study was to analyze the prescribing practices of SGLT2is among endocrinologists, cardiologists, and nephrologists in Indonesia. A qualitative method was utilized to provide a comprehensive understanding of this phenomenon. Semi-structured online interviews were performed with 18 participants, comprising seven specialized doctors as primary informants; eight key informants representing pharmacies, governmental bodies, and pharmaceutical marketing representatives; and three patients as supplementary informants. Furthermore, closed observations of two specialist doctors were undertaken as an additional data collection method. Informants were recruited using criterion and snowball sampling methods. The Theoretical Domains Framework was used as an interview guide; all interviews were audio visual-recorded, transcribed verbatim, and subsequently analyzed for thematic content with NVivo version 12. Seven themes emerged concerning the prescribing behavior of SGLT2is: socioeconomic status, therapeutic rationality, utilization barriers, utilization optimization, the urge to prescribe, therapeutic expectations and targets, and aspects of the health system and ethical considerations. Most informants possessed favorable perspectives regarding using SGLT2is when prescribed appropriately, yet specific elements necessitate enhancement to refine therapeutic justification, including initiatives to incorporate SGLT2is into the national formulary.
Co-Authors Budiman Darmowidjojo, Budiman Cokro, Fonny Em Yunir, Em Esa, Dekta Filantropi Evi Martha Heri setiawan Johan, Michael Leander, Derlin J. Prahasary, Adelia Nova Ramadhani, Rizka Rani Sauriasari, Rani Sihotang, Retta C. Suwita, Christopher Surya