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All Journal Acta Interna : The Journal of Internal Medicine
Raden Bowo Pramono
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Health Professions Medicine & Pharmacology

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The Effect of Telmisartan and Metformin on Insulin Resistance in Metabolic Syndrome Patients with Insulin Therapy oktariani, Siswi; Pramono, Raden Bowo; Sinorita, Hemi
Acta Interna The JOurnal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Acta Interna The JOurnal of Internal Medicine

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Abstract

ABSTRACTBackground: Recommendations for therapy insulin resistance are metformin and thiazolidindion. Sideeffects of thiazolidindion due to peripheral edema occurs to 2-5% and increased 5-15% when combinedwith insulin therapy. Telmisartan, an angiotensin receptor blocker, has anti-hypertensive effects and improveinsulin resistance. Telmisartan effect on peroxisome proliferator activated receptor γ agonist and has the samestructure of the group thiazolidindion, pioglitazone. The research objective was to determine the effectsof telmisartan and metformin on insulin resistance in metabolic syndrome patients with insulin therapy.Methods: This study used a before-after design. The study was conducted in the internal medicine clinic of theendocrinology department of Dr. Sardjito Hospital Yogyakarta. Subjects were patients who met the diagnosis of metabolic syndrome based on the IDF 2005, hypertension and received insulin therapy. Subjects given metforminand telmisartan therapy for 12 weeks. Subjects examined HOMA IR before and after treatment. The averagedecrease in HOMA IR was tested by paired t-test or Wilcoxon test. P value <0.05 was considered signifi cant.Result: The total sample were 27 subjects. Data analysis was performed on 11 subjects. Fasting bloodglucose before and after treatment was signifi cantly decreased (p<0.001) whereas the fasting insulin levelsincreased. HOMA IR was signifi cantly decreased after treatment {p = 0.004 (5.79 – 20.26), CI 95%}.Conclusion: this study found insulin resistance decreased signifi cantly in patients with the metabolicsyndrome of insulin therapy who received metformin and telmisartan.Keywords : metabolic syndrome, insulin therapy, metformin, telmisartan, HOMA IR
The Effect of Telmisartan and Metformin on Insulin Resistance in Metabolic Syndrome Patients with Insulin Therapy Oktariani, Siswi; Pramono, Raden Bowo; Sinorita, Hemi
Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (177.968 KB)

Abstract

ABSTRACTBackground: Recommendations for therapy insulin resistance are metformin and thiazolidindion. Side effects of thiazolidindion due to peripheral edema occurs to 2-5% and increased 5-15% when combined with insulin therapy. Telmisartan, an angiotensin receptor blocker, has anti-hypertensive effects and improve insulin resistance. Telmisartan effect on peroxisome proliferator activated receptor γ agonist and has the same structure of the group thiazolidindion, pioglitazone. The research objective was to determine the effects of telmisartan and metformin on insulin resistance in metabolic syndrome patients with insulin therapy.Methods: This study used a before-after design. The study was conducted in the internal medicine clinic of the endocrinology department of Dr. Sardjito Hospital Yogyakarta. Subjects were patients who met the diagnosis of metabolic syndrome based on the IDF 2005, hypertension and receive insulin therapy. Subjects given metformin and telmisartan therapy for 12 weeks. Subjects examined HOMA IR before and after treatment. The average decrease in HOMA IR was tested by paired t test or Wilcoxon test. P value <0.05 was considered signifi cant.Result: The total sample were 27 subjects. Data analysis was performed on 11 subjects. Fasting blood glucose before and after treatment was signifi cantly decreased (p<0.001) whereas the fasting insulin levels increased. HOMA IR was signifi cantly decreased after treatment {p = 0.004 (5.79 – 20.26), CI 95%}.Conclusion: this study found insulin resistance decreased signifi cantly in patients with the metabolic syndrome of insulin therapy who received metformin and telmisartan.Keywords : metabolic syndrome, insulin therapy, metformin, telmisartan, HOMA IR
The Effect of Telmisartan and Metformin on Insulin Resistance in Metabolic Syndrome Patients with Insulin Therapy Siswi Oktariani; Raden Bowo Pramono; Hemi Sinorita
Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (177.968 KB) | DOI: 10.22146/acta interna.5731

Abstract

ABSTRACTBackground: Recommendations for therapy insulin resistance are metformin and thiazolidindion. Side effects of thiazolidindion due to peripheral edema occurs to 2-5% and increased 5-15% when combined with insulin therapy. Telmisartan, an angiotensin receptor blocker, has anti-hypertensive effects and improve insulin resistance. Telmisartan effect on peroxisome proliferator activated receptor γ agonist and has the same structure of the group thiazolidindion, pioglitazone. The research objective was to determine the effects of telmisartan and metformin on insulin resistance in metabolic syndrome patients with insulin therapy.Methods: This study used a before-after design. The study was conducted in the internal medicine clinic of the endocrinology department of Dr. Sardjito Hospital Yogyakarta. Subjects were patients who met the diagnosis of metabolic syndrome based on the IDF 2005, hypertension and receive insulin therapy. Subjects given metformin and telmisartan therapy for 12 weeks. Subjects examined HOMA IR before and after treatment. The average decrease in HOMA IR was tested by paired t test or Wilcoxon test. P value <0.05 was considered signifi cant.Result: The total sample were 27 subjects. Data analysis was performed on 11 subjects. Fasting blood glucose before and after treatment was signifi cantly decreased (p<0.001) whereas the fasting insulin levels increased. HOMA IR was signifi cantly decreased after treatment {p = 0.004 (5.79 – 20.26), CI 95%}.Conclusion: this study found insulin resistance decreased signifi cantly in patients with the metabolic syndrome of insulin therapy who received metformin and telmisartan.Keywords : metabolic syndrome, insulin therapy, metformin, telmisartan, HOMA IR
The Correlation between Thyroid Hormone Levels with Functional Mobility Performance among the Geriatric Patients in Dr. Sardjito General Hospital Henny Rumaropen; M Robikhul Ikhsan; Raden Bowo Pramono
Acta Interna The Journal of Internal Medicine Vol 10, No 1 (2020): 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.61290

Abstract

Background. Alteration of the endocrine system in the elderly people may be caused by changes in secreted hormone levels or decreased sensitivity of target organs. These changes also apply to thyroid function, which can cause disability, cognitive impairment, cardiovascular risk, and decreased muscle mass and strength in the elderly. Physiologically, there are several changes in the concentration of thyroid hormone Concentrations due to aging process, such as reduced TSH (Thyroid Stimulating Hormone), total T3 (Triiodothyronine) and free T levels, and increased rT3 (Reverse triiodothyronine), which is an inactive T (Thyroxine) metabolite in the serum. Even so,the free T4 and the total T44 remain unchanged, except for the sick. As a result, proper diagnosis and management are expected to minimize the deprivation experienced by the subjects due to a decrease in functional mobility.Aims. The aim of the study was to assess the correlation between the levels of thyroid hormones and functional mobility among the elderly at Dr. Sardjito General Hospital, Yogyakarta.Method. Observational descriptive and analytical study with cross-section design was performed. Subjects were recruited used a consecutive sampling method for subjects who met the inclusion and exclusion criteria. The statistical analysis used to find a correlation between the levels of the thyroid hormone and the performance of the functional mobility by Pearson Correlation test. Here the study used Spearman Correlation test if the conditions were not met the criteria. Significance limit with p < 0.05.Results. A total of 36 research subjects who met the inclusion and exclusion criteria. The mean age was 69.67±6.164 years. Consisted of 16 (44.4%) male and 20 (55.6%) were female. The median of TSH (Thyroid Stimulating Hormone) was 1.170 (0.19-3.64) μIU/mL and the median free T was 1.280 (0.80-2.34) ng/dL. TSH level in male was more than female with same time in gait speed. The male median TSH level was 1.370 (0.60-3.64) μIU/mL and women 0.980 (0.19-3.17) μIU/mL. Slow gait speed more than thirty second (high risk of falling), the TSH mean in mas was 2.690 μIU/mL and women 1.150 μIU/mL. The test results indicate thyroid hormone level has no significant effect on functional mobility performance (timed up and go test score) in the elderly subjects (p value=0.531) and with level Free T4 (p value=0.721).Conclusion: In this study population, thyroid hormones did not have a statistically significant correlation with functional mobility in the elderly. Males with higher serum levels and females with lower serum TSH (Thyroid Stimulating Hormone) were at increased risk of frailty.
Co-Authors Hemi Sinorita Henny Rumaropen M Robikhul Ikhsan Siswi oktariani