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Metabolic Control Status Related to Quality of Life in Children with Type 1 Diabetes Mellitus at Dr. M. Djamil General Hospital Padang Ivanny Khosasih; Asrawati Nurdin; Eka Agustia Rini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 6 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i6.529

Background. Type 1 Diabetes Mellitus (T1DM) is a chronic autoimmune disease requiring lifelong treatment. Good metabolic control could maintain an optimal quality of life. HbA1C is a reliable parameter of metabolic control. Poor metabolic control results in decreased quality of life for T1DM. This study aims to evaluate the relationship between metabolic control status and quality of life in children with T1DM at Dr. M. Djamil General Hospital Padang. Methods. This cross-sectional study on 52 T1DM children aged 8–16 years using consecutive sampling methods at the pediatric endocrinology outpatient clinic, Dr. M. Djamil General Hospital Padang, from April-September 2021. HbA1C was calculated using the High-Performance Liquid Chromatography (HPLC) method and classified into good and poor control. Quality of life was assessed using PedsQl 4.0 and classified as impaired and unimpaired. The Chi-square test was used for data analysis. The P-value of <0.05 was considered statistically significant. Results. The majority of respondents were girls (57.7%), and most of them had good nutritional status (73.1%). The mean age at diagnosis was 11.21±2.57 years, and they had suffered from T1DM for 2.21±1.28 years. A family history of diabetes was found in 57.7% of respondents. Complications found were hypoglycemia (19.2%) and diabetic ketoacidosis (50%). Poor metabolic control was found in 78.8% of respondents. Quality of life was impaired in 40.4% of respondents, especially in school functions. This study found that respondents with impaired quality of life had poor metabolic status (p<0.034). Conclusion. T1DM patients with poor metabolic control status have impaired quality of life.

The Association between 25-(OH)D Level and Metabolic Control Status in Children with Type 1 Diabetes Mellitus at Dr. M. Djamil General Hospital Padang Dini Anggini; Eka Agustia Rini; Finny Fitry Yani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 6 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i6.530

Background. Type 1 diabetes mellitus (T1DM) is an autoimmune disease causing the destruction of pancreatic beta cells. This is an incurable condition, but with good metabolic control, an optimal quality of life can be achieved. Glycated hemoglobin (HbA1C) is still considered a reliable parameter of metabolic control. Studies showed vitamin D has a role in controlling glycemic homeostasis in children with T1DM. Calcidiol or 25-(OH)D is the best parameter to determine the level of vitamin D in the blood. This study aimed to evaluate the association between 25-(OH)D with metabolic control status in T1DM children at Dr. M. Djamil General Hospital Padang. Methods. A cross-sectional study was conducted on 43 pediatric patients with T1DM from July 2019-January 2021. Serum levels of 25-(OH)D were measured by direct CLIA method and classified into deficiency (≤ 20 ng/mL) and insufficiency (21–30 ng/mL). The HbA1C levels were calculated using the HPLC method and classified into good (<7%), adequate (7-8%), and poor (>8%) control. The Chi-square test and ANOVA were used for data analysis. The P-value of < 0.05 was considered statistically significant. Results. The majority of respondents were girls (53.5%), with 90.7% having a good nutritional status. The mean age at diagnosis was 11.25±2.85 years, and had been known to suffer from T1DM for 2.95±1.74 years. All respondents had abnormal levels of 25-(OH)D (100%), i.e., insufficiency (28%), deficiency (72%), poor (65.1%) metabolic control, and 96.4% of respondents with poor metabolic control had a deficiency of 25-(OH)D. (P-value <0.001). Conclusion. T1DM patients who have poor metabolic control have very low levels of 25-(OH)D.

Growth Profile in Pediatric Patients with Diabetes Mellitus at Dr. M. Djamil General Hospital, Padang Michael Mettafortuna Sephberlian; Eka Agustia Rini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 7 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i7.549

Background: Diabetes mellitus (DM) is a glucose metabolism disorder characterized by chronic hyperglycemia that often occurs and is a major health problem. During puberty, increased Growth Hormone (GH) secretion results in increased insulin resistance. This study aimed to describe the growth profile of pediatric patients with diabetes mellitus at Dr. M. Djamil General Hospital. Methods: A descriptive retrospective study with conducted by collecting data on body height, HbA1C level, and status of puberty from medical records at the pediatric ward of Dr. M. Djamil General Hospital from January 2019 - December 2020. Results: The sample was 67 (63 T1DM, 2 T2DM, and 2 double DM). Ten of them with short stature (8 with poor metabolic control). Conclusion: Children with DM may experience growth disturbance.

Association of resistin level with acanthosis nigricans in obese adolescents Dini Noviarti; Eka Agustia Rini; Fadil Oenzil
Paediatrica Indonesiana Vol 56 No 1 (2016): January 2016
Publisher : Indonesian Pediatric Society

Background Childhood obesity is associated with increased risk of cardiovascular diseases and metabolic syndrome, such as insulin resistance. Clinically, insulin resistance may be manifested as acanthosis nigricans. Resistin has a biological activity that is important in glucose and lipid metabolisms and closely related to the incidence of insulin resistance.Objective To find out the association of resistin level with scale of acanthosis nigricans in adolescents obesity.Methods A cross-sectional study was conducted on 53 obese adolescents with acanthosis nigricans in senior high schools in Padang, West Sumatera. Degree of acanthosis nigricans was assessed using scale of Burke and then plasma resistin level was performed with ELISA. Data were analyzed using ANOVA and post-hoc test.Result The mean of resistin level in obese adolescents was 14.21 (SD 7.43) ng/dL. High resistin level was found in scale of acanthosis nigricans 2,3 and 4 (P=0.0001). Obese adolescents with severe degree of acanthosis nigricans has higher resistin level compared to milder acanthosis nigricans.Conclusion In obese adolescents, the higher degree of acanthosis nigricans, the higher level of plasma resistin.

Visfatin levels in non-obese, obese, and insulin resistant adolescents Indra Ihsan; Eka Agustia Rini; Rismawati Yaswir
Paediatrica Indonesiana Vol 56 No 5 (2016): September 2016
Publisher : Indonesian Pediatric Society

Background Adipose tissue is not merely a site for energy storage, but is also the largest endocrine organ, secreting various adipocytokines. Plasma visfatin, an adipocytokine predominantly secreted from visceral adipose tissue, has insulin-mimetic effects, and has been closely linked to insulin resistance.Objective To compare plasma visfatin levels between obese and non-obese adolescents, as well as between obese adolecents with and without insulin resistance.Methods This cross-sectional study was conducted in students who attended three senior high schools in Padang. Subjects comprised 28 obese and 28 non-obese adolescents. The age of the subjects ranged from 14-18 years. Obesity criteria were based on body mass index (BMI) measurements. Fasting serum glucose level was measured by glucose hexokinase photometry and serum insulin was measured by chemiluminesence immunoassay. Plasma visfatin was measured by enzyme-linked immunosorbent assay (ELISA). The insulin resistance index was estimated from fasting serum insulin and glucose levels using the homeostatic model assessment for insulin resistance (HOMA-IR). Differences in the variables were tested using independent T-test and Mann-Whitney test, depending on the distribution of the variables.Results The mean plasma visfatin level was significantly higher in the obese than in the control group [2.55 (SD 1.54) vs. 1.61 (SD 0.64) ng/mL, respectively; (P=0.005)]. The insulin resistant group had significantly higher mean plasma visfatin level than the non-resistant group [3.61 (SD 1.59) vs. 1.96 (SD 1.18) ng/mL, respectively; (P=0.004)].Conclusion Obese adolescents with insulin resistance have signifcantly higher plasma visfatin levels compared to those without insulin resistance.

Cri-du-chat syndrome Eka Agustia Rini; R. Trin Suciati
Paediatrica Indonesiana Vol 47 No 3 (2007): May 2007
Publisher : Indonesian Pediatric Society

Cri-du-chat syndrome (CDCS) is a rare chromosomal disorder, refers to a unique combination of physical and mental characteristics associated with a loss of genetic material on the distal short arm of the fifth chromosome.1 The incidence of CDCS is between 1:25,000 to 1:50,000 births. The prevalence among individuals with mental retardation is about 1.5 in 1000.2 A significant female predominance exists in affected newborns, with a male-to-female ratio of 0.72.2Subtle dysmorphism with neonatal complications and a high-pitched cry typically initiate diagnostic evaluation by cytogenetic studies. 2,3 Currently,there is no cure for cri-du-chat syndrome. The most successful approach in the management of children with CDCS requires a multidisciplinary team approach. 4 The case presented below will remind us how to reveal, suspect and diagnose Cri-Du-Chat syndrome, a rare case in pediatric.

Delayed diagnosis of congenital hypothyroidism in an adolescent results in avoidable complications: a case report Indra Ihsan; Eka Agustia Rini
Paediatrica Indonesiana Vol 57 No 2 (2017): March 2017
Publisher : Indonesian Pediatric Society

Delayed diagnosis of congenital hyporhyroidism (CH) remains a serious problem. A retrospective analysis of 1,000 CH cases in Turkey found a mean age of 49 months at the time of clinical diagnosis. Only 3.1% of cases were diagnosed during the neonatal period and 55.4% were diagnosed after 2 years of age.1 In Cipto Mangunkusumo Hospital, Jakarta, 53% cases were diagnosed at 1-5 years, 3.3% at 6-12 years, and 6.7% after 12 years of age, while the remainder were diagnosed at < 1 year of age.2 The majority of affected children exhibit signs and symptoms that are highly non-specific, as most infants with CH are asymptomatic at birth, and only 5% of cases can be diagnosed based on clinical examination during the first day of life.3 The other factors that contribute to delayed diagnosis are uneducated parents, who do not notice or dismiss the importance of mild/moderate deviations in physical and mental growth, as well as constipation, feeding difficulties, or other vague, non-specific symptoms in infancy. Parents are often unaware of the importance of early diagnosis and commencement of therapy for CH.4

Late Onset Hypocalcemia Caused by Hypovitaminosis D Dini Anggini; Eka Agustia Rini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 10 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i10.415

Background: hypocalcemia is a common metabolic problem in neonates and infants that can be life threatening. The incidence of hypocalcemia leads to complications and developmental disorders in children. Case presentations: A 1 month-old boy with hypovitaminosis D and a history of recurrent hypocalcemia since one week of age. The patient had repeated seizures at the age of 7 days without fever and hypoglycemia, the overall physical examination was within normal, the results of the lumbar puncture were within normal limits. Laboratory examinations at that time showed low of serum calcium, urinary calcium, calcium ion and vitamin D levels, while magnesium, phosphorus and parathyroid hormone (PTH) levels were within normal limits. The patient was diagnosed with late onset hypocalcemia caused by hypovitaminosis D. The patient was given vitamin D therapy, calcium lactate, and intravena calcium correction was performed. Conclusion: late onset hypocalcemia occurring after the first 7 days of life was associated with hyperparathyroidism, high phosphate formula administration, DiGeorge syndrome, hypomagnesemia, and vitamin D deficiency.

Metabolic Control Status Related to Quality of Life in Children with Type 1 Diabetes Mellitus at Dr. M. Djamil General Hospital Padang Ivanny Khosasih; Asrawati Nurdin; Eka Agustia Rini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 6 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i6.529

Background. Type 1 Diabetes Mellitus (T1DM) is a chronic autoimmune disease requiring lifelong treatment. Good metabolic control could maintain an optimal quality of life. HbA1C is a reliable parameter of metabolic control. Poor metabolic control results in decreased quality of life for T1DM. This study aims to evaluate the relationship between metabolic control status and quality of life in children with T1DM at Dr. M. Djamil General Hospital Padang. Methods. This cross-sectional study on 52 T1DM children aged 8–16 years using consecutive sampling methods at the pediatric endocrinology outpatient clinic, Dr. M. Djamil General Hospital Padang, from April-September 2021. HbA1C was calculated using the High-Performance Liquid Chromatography (HPLC) method and classified into good and poor control. Quality of life was assessed using PedsQl 4.0 and classified as impaired and unimpaired. The Chi-square test was used for data analysis. The P-value of <0.05 was considered statistically significant. Results. The majority of respondents were girls (57.7%), and most of them had good nutritional status (73.1%). The mean age at diagnosis was 11.21±2.57 years, and they had suffered from T1DM for 2.21±1.28 years. A family history of diabetes was found in 57.7% of respondents. Complications found were hypoglycemia (19.2%) and diabetic ketoacidosis (50%). Poor metabolic control was found in 78.8% of respondents. Quality of life was impaired in 40.4% of respondents, especially in school functions. This study found that respondents with impaired quality of life had poor metabolic status (p<0.034). Conclusion. T1DM patients with poor metabolic control status have impaired quality of life.

The Association between 25-(OH)D Level and Metabolic Control Status in Children with Type 1 Diabetes Mellitus at Dr. M. Djamil General Hospital Padang Dini Anggini; Eka Agustia Rini; Finny Fitry Yani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 6 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i6.530

Background. Type 1 diabetes mellitus (T1DM) is an autoimmune disease causing the destruction of pancreatic beta cells. This is an incurable condition, but with good metabolic control, an optimal quality of life can be achieved. Glycated hemoglobin (HbA1C) is still considered a reliable parameter of metabolic control. Studies showed vitamin D has a role in controlling glycemic homeostasis in children with T1DM. Calcidiol or 25-(OH)D is the best parameter to determine the level of vitamin D in the blood. This study aimed to evaluate the association between 25-(OH)D with metabolic control status in T1DM children at Dr. M. Djamil General Hospital Padang. Methods. A cross-sectional study was conducted on 43 pediatric patients with T1DM from July 2019-January 2021. Serum levels of 25-(OH)D were measured by direct CLIA method and classified into deficiency (≤ 20 ng/mL) and insufficiency (21–30 ng/mL). The HbA1C levels were calculated using the HPLC method and classified into good (<7%), adequate (7-8%), and poor (>8%) control. The Chi-square test and ANOVA were used for data analysis. The P-value of < 0.05 was considered statistically significant. Results. The majority of respondents were girls (53.5%), with 90.7% having a good nutritional status. The mean age at diagnosis was 11.25±2.85 years, and had been known to suffer from T1DM for 2.95±1.74 years. All respondents had abnormal levels of 25-(OH)D (100%), i.e., insufficiency (28%), deficiency (72%), poor (65.1%) metabolic control, and 96.4% of respondents with poor metabolic control had a deficiency of 25-(OH)D. (P-value <0.001). Conclusion. T1DM patients who have poor metabolic control have very low levels of 25-(OH)D.

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