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All Journal Acta Interna : The Journal of Internal Medicine Journal of the Medical Sciences (Berkala Ilmu Kedokteran) AcTion: Aceh Nutrition Journal CoMPHI Journal : Community Medicine and Public Health of Indonesia Journal Indonesian Journal of Biomedicine and Clinical Sciences
Susanti, Vina Yanti
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Comparison of the Effectiveness of Subcutaneous Insulin Injection between Upper Arm and Abdominal Sites in Type II Diabetes Mellitus Patients with Normal and Above Normal Body Mass Index Khairina, Ana; Ihsan, Mohammad Robikhul; Susanti, Vina Yanti
Acta Interna The Journal of Internal Medicine Vol 11, No 1 (2021): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.94630

Abstract

Background. Type II Diabetes Mellitus (DM) has high morbidity and mortality. One of DM therapy is insulin. Insulin effectiveness is affected by the injection site and the thickness of the fat in the injection site. Several studies on the effectiveness of insulin injection sites have been conducted, but the results still vary.Objective. To determine the difference in the effectiveness of subcutaneous insulin injections between the upper arm and abdominal sites on changes in capillary glucose levels in type II diabetes mellitus patients with normal and above-normal body mass index (BMI).Methods. The research design used a quasi-experimental repeated measure design. The research subjects were patients diagnosed with type II DM, age ≥ 40 years, hospitalized in the ward of Dr. Sardjito Hospital Yogyakarta. The effectiveness of insulin injection is described by the difference between 2-hours postprandial glucose (2hPPG) minus fasting blood glucose (FBG) (Δ2hPPG-FBG). Δ2hPPG-FBG was taken on the site of the upper arm and abdomen. Patients were classified based on normal and above normal BMI. Statistical analysis was performed using paired T-tests.Result. There were 14 patients with normal BMI and 11 patients with above normal BMI. Paired T-test showed a significant difference in Δ2hPPG-FBG between the upper arm and abdominal sites in normal BMI patients (p=0.028) with a mean of Δ2hPPG-FBG for the upper arm site of 26,14±38.18 mg/dL, and a mean of Δ2hPPG-FBG of the abdominal site -0.64±50,62 mg/dL. Paired T-test showed no significant difference in Δ2hPPG-FBG between the upper arm and abdominal sites in patients with an above-normal BMI (p = 0.239).Conclusion. The effectiveness of subcutaneous insulin injection in the abdominal site was better than in the upper arm site in patients with normal BMI. There was no difference in the effectiveness of subcutaneous insulin injection between the upper arm and abdominal sites in patients with an above-normal BMI.
The Relationship of Thyroid Stimulating Hormone Receptor Antibody (TRAb) Levels to Activity and Clinical Severity of Graves' Ophthalmopathy in RSUP Dr. Sardjito Putra, Kharisma Wibawa Nurdin Putra; Ikhsan, M. Robikhul; Susanti, Vina Yanti
Acta Interna The Journal of Internal Medicine Vol 12, No 2 (2023): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.98252

Abstract

Background: Graves' disease (GD) is an autoimmune disease that is the most common cause of hyperthyroidism. Thyroid stimulating hormone receptor antibody (TRAb) is a specific biomarker for diagnosing GD. Graves' ophthalmopathy (GO) is the most common extrathyroid manifestation in Graves'. Each GO was assessed for activity and clinical severity for treatment.Objectives: To determine the relationship between TRAb levels and GO clinical activity in Clinical Activity Score (CAS) classification and clinical severity of The European Group on Graves' Orbitopathy (EUGOGO).Methods:  This is a cross-sectional study, conducted from January to August 2021 at RSUP Dr. Sardjito Yogyakarta. 30 newly diagnosed Graves' patients or previously diagnosed with Graves' presented symptoms of hyperthyroidism were included. The patients had TRAb levels > 1.75 IU/L, and diagnosed with Graves' ophthalmopathy based on clinical criteria according to Bartley and Gorman and has not received steroid injections. Serum TRAb examination by electrochemiluminescence immunoassay (ECLIA) method. Clinical activity are assessed with CAS, while severity are assessed with EUGOGO criteria. The data are analyzed using Spearman correlation, multivariate analysis with linear regression and logistic regression.Results: 30 study subjects mean age 35.43 years, female dominant (80%), median GD duration of 13 months. Median TRAb 8.15 IU/L, median CAS score 2 with 46.3% active. Mild severity 40% and moderate-severe 60%. Correlation of TRAb with CAS (r=0.576, p=0.001), EUGOGO (r=0.535, p=0.002). Multivariate analysis of TRAb with CAS (B= 0.076, p=0.01) while EUGOGO (OR=1.198, p=0.045)Conclusion: TRAb is positively correlated with activity and clinical severity of OG.
Hubungan Hipertensi Terhadap Kematian Pasien Covid-19 Dengan Diabetes Melitus Tipe 2 di RSUP dr. Sardjito Fadhilah, Farah; Susanti, Vina Yanti; Nugroho, Dhite Bayu; Adhikara, Imam Manggalya; Handajani, Fitri
CoMPHI Journal: Community Medicine and Public Health of Indonesia Journal Vol. 4 No. 3 (2024): Februari
Publisher : Perhimpunan Dokter Kedokteran Komunitas dan Kesehatan Masyarakat Indonesia (PDK3MI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37148/comphijournal.v4i3.199

Abstract

Diabetes mellitus and hypertension are co-morbidities that are often found in COVID-19 patients. Diabetes can reduce the body's immunity and increase the rate of viral replication, and is associated with vascular problems. Hypertension is one of the comorbid diabetes with high morbidity and mortality. To determine the relationship between hypertension and the death of COVID-19 patients with type 2 diabetes mellitus at Dr Sardjito General Hospital. Observational study with a retrospective cohort study design, using COVID-19 registry data at Dr Sardjito General Hospital for the period March 2020-July 2021. COVID-19 patients with type 2 diabetes mellitus who had hypertension and those who did not have hypertension were selected at Dr Sardjito General Hospital and Collected data on mortality, age, sex, other comorbidities, severity and length of stay. Data were processed using SPSS, in univariate, bivariate, and multivariate analysis models. the results of multivariate analysis using logistic regression found that hypertension, age, and ischemic heart disease did not have a significant association with the death of COVID-19 patients with type 2 diabetes mellitus. The variable that had the greatest power as a predictor of death in COVID-19 patients with diabetes mellitus type 2 is ARDS with a risk of death 20.8 times higher than without ARDS. Patients with kidney failure are at risk of dying 2.7 times higher than those without kidney failure. The addition of length of stay (LOS) 1 day of treatment reduces the risk of death by 16.3%. Hypertension has no significant relationship as a predictor of death in COVID-19 patients with type 2 diabetes mellitus at Dr Sardjito General Hospital. Significant predictors of death in this study were ARDS, kidney failure, and were associated with length of stay (LOS).  
Complete recovery of severe coronavirus disease 2019 (COVID-19) infection in an obese patient Susanti, Vina Yanti; Anggraeni, Vita Yanti; Akbar, Adrianus; Leo, Benedreky
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 3 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005503202308

Abstract

There is strong evidence indicating that excess adiposity in obesity impacts immune function and host defence. However, almost no known mechanism of how the immune and host defence are affected by the low-grade inflammatory response of the obese has been established. The significance of altered immune response in obesity was presumed to be an independent risk factor for increased morbidity and mortality following the influenza pandemic back in 2009. Similarly, obesity is linked with a higher risk of severity and a worse clinical outcome of severe acute respiratory coronavirus 2 (SARS-COV-2) infection.This case reports a complete recovery of a severe coronavirus disease 2019 (COVID-19) infection despite having morbid obesity aggravated by metabolic syndrome.
Management of non-malignant hyperinsulinemic hypoglycaemia in resource limited setting: a case report Susanti, Vina Yanti; Vita Yanti Anggraeni; Leo, Benedreky
Indonesian Journal of Biomedicine and Clinical Sciences Vol 56 No 2 (2024)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v56i2.13028

Abstract

A 37 y.o. Asian male presented with frequent hypoglycaemia in both fasting and post-prandial state. He had elevated blood insulin levels during the hypoglycaemic episodes with normal pancreatic morphology and no extra-pancreatic tumor. Through systematic symptom assessment and the use of simple laboratory examination, non-insulinoma pancreatogenous hypoglycaemia syndrome presented as the most likely diagnosis. Conclusive aetiological diagnosis could not be reached due to the limited availability of diagnostic modalities. Nevertheless, modest symptom control and frequency reduction of hypoglycaemia were achieved with empirical dietary modification and α-glucosidase inhibitor treatment.
Effect of low glycemic index diet on HbA1c in type 2 diabetes mellitus: A systematic review and meta-analysis in Asia Wahyuni, Fani Cahya; Nisa, Ainun; Wiratama, Bayu Satria; Huriyati, Emy; Susanti, Vina Yanti
AcTion: Aceh Nutrition Journal Vol 11, No 1 (2026): March
Publisher : Department of Nutrition at the Health Polytechnic of Aceh, Ministry of Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30867/action.v11i1.2585

Abstract

Diabetes mellitus affects 10.5% of the global population, and its prevalence is expected to increase by 2045. Type 2 diabetes mellitus (T2DM) is commonly associated with abnormal HbA1c levels, lipid metabolism, and body mass index (BMI). A low glycemic index (GI) has been proposed to improve HbA1c, lipid profiles, and BMI, but the findings remain inconsistent, and most studies have been conducted in non-Asian populations. This study evaluated the effect of a low-GI diet on HbA1c levels in Asian adults with T2DM. Systematic searches in the PubMed, ScienceDirect, and Scopus databases identified randomized controlled trials (2014-2024) involving adults (≥18 years) with T2DM, excluding pregnant and breastfeeding women. Meta-analysis and subgroup analysis were conducted, and meta-regression was used to assess the moderators.  Study quality was assessed using the ROB-2 and GRADE. Of the 1,485 articles screened, 16 met the inclusion criteria. The low-GI diet significantly reduced HbA1c and LDL levels and increased HDL levels. Subgroup analysis showed variations between the intervention and control groups, with the percentage of female participants and supplementation type as potential moderators. Despite statistical significance, the small effect size, heterogeneity, and low-to-moderate certainty of evidence (GRADE) suggest limited clinical relevance. Further research should consider the sample size, female proportion, and type of intervention in the control group to strengthen the evidence for clinical and policy applications.
Co-Authors Adhikara, Imam Manggalya Akbar, Adrianus Anggraeni, Vita Yanti Bayu Satria Wiratama Emy Huriyati Fadhilah, Farah Handajani, Fitri Ihsan, Mohammad Robikhul Ikhsan, M. Robikhul Khairina, Ana Leo, Benedreky Nisa, Ainun Nugroho, Dhite Bayu Putra, Kharisma Wibawa Nurdin Putra Vita Yanti Anggraeni Wahyuni, Fani Cahya