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All Journal Medicina journal of internal medicine E-Jurnal Medika Udayana E-Jurnal Udayana Medica MNJ (Malang Neurology Journal) The Indonesian Biomedical Journal Jurnal Penyakit Dalam Udayana ISM (Intisari Sains Medis) : Jurnal Kedokteran Medical and Health Science Journal Neurologico Spinale Medico Chirurgico Bioscientia Medicina : Journal of Biomedicine and Translational Research GANESHA MEDICINA Jurnal Indonesia Sosial Sains Journal of Global Pharma Technology Asian Journal of Social and Humanities Jurnal Ekonomi Kesehatan Indonesia Indonesian Journal of Endocrinology Metabolism and Diabetes (InaJEMD)
MADE RATNA SARASWATI .
Bagian Ilmu Penyakit Dalam RSUP Sanglah, Fakultas Kedokteran Universitas Udayana
Humanities Astronomy Biochemistry, Genetics & Molecular Biology Chemistry Computer Science & IT Decision Sciences, Operations Research & Management Earth & Planetary Sciences Economics, Econometrics & Finance Energy Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Library & Information Science Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Physics Public Health Social Sciences

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Diabetes Risk Allele of Transcription Factor 7-like 2 (TCF7L2) Polymorphisms is Associated with Higher Glucagon-like Peptide 1 (GLP1) and Lower Insulin Secretion Saraswati, Made Ratna; Suastika, Ketut; Budhiarta, Anak Agung Gde; Oktavianthi, Suksma; Malik, Safarina G.
The Indonesian Biomedical Journal Vol 16, No 5 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i5.3202

Abstract

BACKGROUND: The most influential susceptible gene associated with diabetes, transcription factor 7-like 2 (TCF7L2), has been observed in diverse populations. TCF7L2 influences type 2 diabetes risk through glucagon-like peptide 1 (GLP1) production. The presence of risk allele of TCF7L2 leads to the alteration of gene expression in pancreatic beta cells; however, how the mechanism is related with GLP1 remains unclear. This study was conducted to explore the variations of GLP1 increment and insulin secretion between individuals with and without diabetes risk allele of single nucleotide polymorphisms (SNPs) in TCF7L2.METHODS: A cross-sectional analytic study was conducted involving individuals subjects who harbored known variants of SNPs in the TCF7L2: heterozygote or mutant of rs12255372 (GT or TT), rs7903146 (CT or TT), rs10885406 (AG or GG); as well as control subjects with wild type of rs12255372 (GG), rs7903146 (CC), and rs10885406 (AA). Anthropometric parameters, blood glucose, insulin, and GLP1 were measured; and homeostasis model assessment-beta cell (HOMA-%B) index was calculated.RESULTS: The GLP1 increment response was higher in subjects carrying the diabetes risk allele (0.34±0.80 ng/mL) than those with the wild type (-0.04±0.57 ng/mL) (p=0.041). The HOMA-%B was reduced in subjects carrying the diabetes risk allele (71.64±24.72) than those with the wild type (103.23±68.00) (p=0.011). Among individuals carrying the diabetes risk allele, the likelihood of GLP1 increment with high response was twice as high (p=0.007), while the occurrence of low HOMA-%B was 1.47 more frequent (p=0.011).CONCLUSION: TCF7L2 polymorphisms were associated with the GLP1 increment response and reduced HOMA-%B, which might be potentially contributing to GLP1 resistance in patients with diabetes risk factors.KEYWORDS: diabetes risk, TCF7L2, GLP1, HOMA-%B
Analisis Ekonomi dan Dampak Pandemi COVID-19 terhadap Kunjungan Pasien Diabetes: Studi Kasus Poliklinik Pusat Diabetes RS Ngoerah, Bali, Indonesia Saraswati, Made Ratna; Ayuningtyas, Dumilah
Jurnal Ekonomi Kesehatan Indonesia Vol. 10, No. 1
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

The COVID-19 pandemic has significantly impacted community activities, including social and economic aspects, as well as health behavior and healthcare services. Diabetes Mellitus (DM) is a chronic disease that requires continuous management to prevent chronic complications. Ngoerah Hospital (RS Ngoerah), Bali, Indonesia, is a type A hospital where DM patients generally present with complications. This study analyzes the impact of the COVID-19 pandemic on DM patient visits to the Diabetes Center Polyclinic at RS Ngoerah by considering economic aspects. This research is a retrospective study of patient visit data to the Diabetes Center Polyclinic at RS Ngoerah from 2019 to 2024, covering the time before, during, and after the COVID-19 pandemic. A descriptive analysis was carried out to observe changes in patient visits during each period. Furthermore, an aggregate analysis was conducted to examine the correlation between the number of patient visits and the number of detected COVID-19 cases, the COVID-19 pandemic timeline along with government regulations during the pandemic, and the economic condition reflected by the Gross Regional Domestic Product (GRDP) of Bali Province in the same year. The COVID-19 pandemic led to a decrease of up to 58.65% in DM patient visits to the Diabetes Center Polyclinic at Ngoerah Hospital. Directly, there was no significant correlation between the number of reported COVID-19 cases in Bali Province and the number of DM patient visits to the Diabetes Center Polyclinic at RS Ngoerah (r=0.262, p=0.155); however, other factors influencing the number of patient visits included government policies during the COVID-19 pandemic and the GRDP
Diagnostic Problems and Monitoring Of Diabetes Mellitus In Patients With Aplastic Anemia and Hypoalbuminemia Gautama M, Putu Gizha Satrya; Saraswati, Made Ratna
Jurnal Indonesia Sosial Sains Vol. 6 No. 12 (2025): Jurnal Indonesia Sosial Sains
Publisher : CV. Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/jiss.v6i12.2075

Abstract

Aplastic anemia is a clinical syndrome that occurs due to bone marrow failure. One of the most common metabolic complications is diabetes mellitus (DM). The emergence of DM allegedly caused by damage of pancreatic β cells due to accumulation of Fe post-transfusion as well as longterm steroid treatment during the patient's care. This case reported a 41-year-old male patient with steroid-resistant aplastic anemia since 8 years ago, exceeding iron, and moderate malnutrition with hypoalbuminemia. He routinely received red blood cell transfusions and steroid therapy. Since 3 months ago the patient felt classic DM symtomps. Initial laboratory examination found there were normochromic normocytic anemia and thrombocytopenia. Hyperglycemia, hypoalbuminemia, high glycated hemoglobin (HbA1C) levels, and normal glycated albumin (GA) levels were also obtained. Patient was diagnosed with DM. He was treated with medical nutrition therapy, red blood cell transfusion, human albumin transfusion, insulin, and his blood glucose were monitored regularly. Monitoring of glycemic control in DM patients is essential since DM is a chronic disease. In this case, the patient’s glycemic control assessment was using a combination of several methods and biomarkers, such as HbA1C, GA, and eAG (fasting glucose and post prandial glucose).
Diagnostic and Management of Idiophatic Panhypopituitarism A Case Report Ida Bagus Aditya Nugraha; Komang Agus Wira Nugraha; Anak Agung Gede Budhiarta; Ketut Suastika; Wira Gotera; Made Ratna Saraswati; I Made Pande Dwipayana; I Made Siswadi Semadi
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes Vol. 1 No. 1 (2024): InaJEMD Vol. 1, No. 1
Publisher : PP PERKENI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66266/inajemd.v1i1.5

Abstract

Hypopituitarism is marked by decreased secretion of one, several, or all anterior or posterior pituitary hormones. A rare disorder, panhypopituitarism indicates the loss of all the pituitary hormones but often is used in clinical practice to describe a patient's deficiency in growth hormone, gonadotropins, corticotropin, and thyrotropin in whom the posterior pituitary function remains intact. Hypopituitarism may occur because of diverse etiologies and lead to substantial morbidity and mortality. Despite advances in the diagnosis and management of pituitary disorders, hypopituitarism is still associated with increased long-term cardiovascular mortality. We report a rare case of a 22-year-old boy with idiopathic panhypopituitarism. The patient has deficiency of growth hormone, gonadotropin, corticotropin, and thyrotropin, yet the underlying etiology remains unknown in this patient because of lack of imaging data. This is very challenging to do prompt diagnosis and management of panhypopituitarism. The management is needing multiple hormonereplacement therapy, based on the result of pituitary hormone laboratory examination. Prompt treatment is needed to prevent further morbidity and mortality in this patient. hypothyroidism, growth hormon
HIGH RISK OF OBSTRUCTIVE SLEEP APNEA, OBESITY, MELATONIN LEVELS, AND C-REACTIVE PROTEIN IN INDIVIDUALS WITH AND WITHOUT DIABETES MELLITUS: A COMPARATIVE STUDY Indrasari Utami, Desak Ketut; Saraswati, Made Ratna; Ariyanti Putri, Putu Dian; Yustiantara, Putu Sanna; Pikatan, Orlando
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.02.01

Abstract

Background: Sleep is a fundamental pillar for maintaining metabolic, endocrine, and cardiovascular stability. However, individuals diagnosed with Type 2 Diabetes Mellitus (T2DM) are disproportionately susceptible to sleep-related disorders, particularly Obstructive Sleep Apnea (OSA). This relationship is often bidirectional, where sleep disturbances can exacerbate insulin resistance and negatively impact the overall prognosis of the disease. Objective: The primary goal of this study was to conduct a comparative analysis between diabetic and non-diabetic individuals regarding sleep quality, OSA risk, and obesity prevalence. Additionally, the research aimed to investigate whether these clinical factors correlated with differences in specific biomarkers, specifically melatonin and C-reactive protein (CRP) levels. Methods: A cross-sectional study was conducted at Ngoerah General Hospital involving 52 participants that fulfilled the eligibility criteria (26 with T2DM and 26 without). Sleep assessment was using the PSQI, Epworth Sleepiness Scale, and STOP-BANG questionnaire. Anthropometric measurements were taken, and blood samples were analysed for melatonin and CRP levels using ELISA. Results: In a cohort of 52 participants (divided evenly into 26 with T2DM and 26 without), significant clinical disparities were observed. The diabetic group demonstrated a much higher prevalence of poor sleep quality (61.5%) compared to the non-diabetic group (26.9%, p=0.012). Similarly, the risk of high-grade OSA was substantially more common among diabetic patients (42.3%) than in the control group (7.7%, p=0.004), with obesity present exclusively in the diabetic cohort (19.2%). Despite these findings, there were no statistically significant differences between the two groups regarding daytime sleepiness, CRP levels (p=0.634), or melatonin concentrations (p=0.194). Conclusion: Patients with T2DM exhibit a significantly higher burden of sleep dysfunction, obesity, and OSA risk compared to individuals without diabetes. However, these physical manifestations did not translate into distinct variations in CRP or melatonin levels in this study. These results highlight the necessity for a holistic approach to diabetes management that actively integrates sleep and circadian health, while suggesting that further longitudinal research is needed to clarify the behavior of these biomarkers over time.
Co-Authors A.A Sagung Ika Nuriska A.A.Gde Budhiarta Agus Santosa Ake, Anselmus Anak Agung Gde Budhiarta Anak Agung Gde Budhiarta Anak Agung Gede Ari Nanda Bhaswara Anak Agung Gede Budhiarta Anak Agung Gede Mahaindra Putra Andika Budiartha, Putu Gede Ariyanti Putri, Putu Dian Azizah, Norma Nur Azizah Bondan Winarno Budhiarta, Anak Agung Gde Budi Ratna Aryani David Dharmawan Harjanto Devinta, Made Ratih Santi Dewa Ayu Sri Agung Suandewi Dewi, Putu Feby Miswari Dumilah Ayuningtyas Eti Kurniaty Gautama M, Putu Gizha Satrya Gede Agung Widya Iswara Gede Andrewartha Gozali, Theodorus Onesiforus Herawati Sudoyo I Gde Raka Widiana I Gde Suranaya Pandit I Gusti Ayu Sri Mahendra Dewi I Gusti Ngurah Kade Mahardika I Gusti Putu Suka Aryana I Ketut Suastika I Ketut Sustika I Made Ady Wirawan I Made Bagiada I Made Pande Dwipayana I Made Siswadi Semadi I Made Siswadi Semadi I Made Siswadi Semadi I Made Yoga Prabawa I Wayan Eka Satriawibawa I Wayan Hartadi Noor I Wayan Losen Adnyana I Wayan Putu Sutirta Yasa I Wayan Sudhana I Wayan Sumardika I. K. Suastika Ida Bagus Aditya Nugraha Ida Bagus Yorky Brahmantya Indrasari Utami, Desak Ketut Isabella Soerjanto Putri K Suastika Kadek Dina Puspitasari Kartadinata, Sarah Levina Ketut Suega Komang Agus Wira Nugraha Laksmi, Putu Pradnyasanti Made Ayu Devi Pita Loka Made Yogi Krisnanda Malik, Safarina G. Marisye Christantia Mayura, I Gusti Ngurah Mochtar, Fransiska Muhammad Aris Sugiharso Ni Ketut Rai Purnami Ni Luh Made Novi Ratnasari Ni Luh Putri Kresnasari Ni Made Sintia Anggia Sari Nym Astika Nyoman Arya Shridewi Abhigamika Oktavianthi, Suksma Pande Ayu Naya Kasih Permatananda Parastan, Rovie Hikari Pikatan, Orlando Prichilia Sarah Permadi R. Prawira Bayu Putra Dewa Ratih Pradnyandari Pemayun Rena, Ni Made Renny Anggreni Rheza Priyadi Rooseno, Ratna Rayeni Natasha Rusditha, Sarah - S., Hantono Safarina G. Malik Savitri, Putu Dian Hermawati Sari Sukma Oktavianthi Surya Sanjaya Funistera Susy Purnawati Tuty Kuswardani Wan Muhamad Syafiq Wardana, Rr. Cattleya Allayka Wimpie I Pangkahila Wira Gotera Yustiantara, Putu Sanna ¬Ni Putu Ade Tiwi Tyastarini Tyastarini