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Faktor-Faktor Risiko Kejadian Kaki Diabetik pada Penderita Diabetes Melitus Tipe 2 (Studi Kasus Kontrol di RSUP dr. M. Djamil Padang) Rina Rina; Henry Setyawan; Heri Nugroho; Suharyo Hadisaputro; Tjokorda Gde Dalem Pemayun
Jurnal Epidemiologi Kesehatan Komunitas Vol 1, No 2: Agustus 2016
Publisher : Master of Epidemiology, School of Postgraduate Studies, Diponegoro University, Indonesia

Background : Diabetic foot is one of the chronic complications of diabetes mellitus and are the most feared by people who suffer of diabetes mellitus as it can lead to disability or even death. This more specific research on risk factors of the ethnic communities of the Minangkabau society. The purpose of this research is to prove the factors related to the incidence of diabetic foot in people with type 2 diabetes mellitus.Methods : The research applied with mix method were quantitative as the main approach (case control design) and qualitative as support (indepth interview). Target population is all people with a diagnosis of type 2 diabetes mellitus in Padang City, West Sumatera Province there were 172 respondent involved, consisting of 86 cases and 86 controls with concequtive sampling technique. Data analysis included univariat and bivariat analysis using the chi square test and mu ltivariate analysis using multiple logistic regression test.Results : Factors proven to correlate with the incidence of diabetic foot in patients with type 2diabetes mellitus are deformities in legs (p=<0,001), habit of smoking (p=<0,001), age ≥45 years (p=<0,001; OR=27,6; 95%CI=3,96-193,23), a series of ulceration on the legs (p=0,001;), and hypertension (p=0,001), with the probability of 95,88%. Protective factors on the incidence of diabetic foot in patients with type 2 diabetes mellitus is a gender (p=0,002).Conclusion : Risk factors to the incidence of diabetic foot are related of the deformities in the foot, smoking, age, leg ulceration and hypertension

Beberapa Faktor yang Berpengaruh terhadap Kejadian Diabetes Mellitus Tipe 2 pada Wanita Usia Subur (WUS) di RSUD Kota Madiun Hanifah Ardiani; Suharyo Hadisaputro; Djoko Trihadi Lukmono; Heri Nugroho; Antono Suryosaputro
Jurnal Epidemiologi Kesehatan Komunitas Vol 3, No 2: Agustus 2018
Publisher : Master of Epidemiology, School of Postgraduate Studies, Diponegoro University, Indonesia

Background : Women of reproductive age with Diabetes Mellitus (DM) who were married having a risk complications of pregnancy, either on mother and her baby. Study on risk factors of DM in women of reproductive age was a rare, they have never done on women of reproductive age that married. The objective of this study was to prove some variables that inﬂuence to DM in women of reproductive age.Method : An observasional analytic was conducted with case-control study design. Populations in this study were women of reproductive age 20-49 years that check blood sugar at Madiun Regional Hospital. The samples in this study were 54 cases and 54 controls by consecutive sampling. Data were analyzed by chi-square and logistic regression.Results : Women of reproductive age with 2 and 3 quartile stress scores had risk 4,12 (95% CI=1,42-11,92) and 5,64 (95% CI=1,19-16,55) greater for DM than the comparison group. Women of reproductive age with physical activity <600 MET had risk 4,33 times greater for DM than ≥ 600 MET (95% CI = 1,71-10,96).Conclusion : Variables levels of carbohydrate and fat consumption were not associated with DM. Physical activity and stress levels were evident inﬂuece DM occurence in women of reproductive age.

Hubungan Status Merokok dengan Kejadian Ulkus Diabetikum pada Laki-Laki Penderita Diabetes Melitus Shofia Aji Hidayatillah; Nugroho Heri; Mateus Sakundarno Adi
Jurnal Epidemiologi Kesehatan Komunitas Vol 5, No 1: Februari 2020
Publisher : Master of Epidemiology, School of Postgraduate Studies, Diponegoro University, Indonesia

Background: The incidence of diabetic ulcers in Indonesia is 12% and the risk of diabetic ulcers is 55.4% .10 Cases of diabetic ulcers and gangrene in Indonesia are the most known cases in hospitals. Mortality due to ulcers and gangrene ranges from 17-23%, while the amputation rate starts at 15-30%. Diabetic ulcers are the most common complication in people with Diabetes Mellitus (DM). The purpose of this study is to study the relationship of smoking with the incidence of diabetic ulcers in men with DM. The study design in this study is case control.Methods: This research was conducted in the outpatient and inpatient installation of RSUD dr. Loekmono Hadi Kudus Regency and RSI Sunan Kudus on August - September 2019. The population in this study were men with DM who received 25−80 years who had a health examination at dr. Loekmono Hadi Kudus Regency and RSI Sunan Kudus. A total of 35 cases and 35 controls were selected using consecutive sampling. Data were analyzed with chi square.Result: The results showed a significant relationship between smoking and the incidence of diabetic ulcers in men with DM (p = 0.030; 95% CI = 1,235-8,997) and physical activity (p = 0.015; 95% CI = 1,401-10,590).Conclusion: In this study, smoking and physical activity are related with the incidence of diabetic ulcers in men who are diabetic patients.

Faktor yang Berpengaruh terhadap Kegagalan Pengendalian Diabetes Melitus Tipe 2 pada Pasien yang Berobat di PT. Askes Cabang Sampit Kabupaten Kotawaringin Timur Diana Diana; Heri Nugroho; Suharyo Hadisaputro
Jurnal Epidemiologi Kesehatan Komunitas Vol 2, No 1: Februari 2017
Publisher : Master of Epidemiology, School of Postgraduate Studies, Diponegoro University, Indonesia

Background: Diabetes mellitus is a chronic disease characterized by blood glucose levels than normal, impaired metabolism of carbohydrates, fats and proteins caused by a deﬁciency of the hormone insulin relative or absolute. Control of blood sugar in people with DMT 2 is an essential requirement for delaying complications, in the community. DMT 2 risk factor is age, long- suffering, sex, education, socio-economic, knowledge, attitudes, practices, patterns of diet, obesity, how to take medication, exercise, family support, educate physicians and nutritionists. The purpose ofthe study describes some of the factors that inﬂuence the DMT2 control failure.Methods: The study used a case-control design is reinforced by the qualitative study. The number of respondents was 122, including 61 cases and 61controls taken by consecutive sampling. Analysis ofthe data using univariate, bivariate (chi-square) and multivariate (logistic regression).Results: Analysis of some factors that inﬂuence the attitude control DMT 2 (OR 34.4), exercise (OR 8.7), knowledge (OR 8,4), age (OR 5.9), family support (OR 5.2), how totake medication (OR 3.5). Various factors were not shown to signiﬁcantly affect the failure to control type 2 diabetes mellitus are: Long suffering, sex, smoking, education, socio-economic, diet, obesity, stress/depression, education of physicians and nutritionists.Conclusion: Several factors were shown to inﬂuence the incidence of DMT 2 control attitude, exercise, knowledge, age, family support, and how to take the medicine.

Faktor Risiko yang Berpengaruh terhadap Terjadinya Hipertensi pada Penderita Diabetes Melitus Tipe II di Wilayah Puskesmas Kabupaten Pati Gracilaria Puspa Sari; Shofa Chasani; Tjokorda Gde Dalem Pemayun; Suharyo Hadisaputro; Heri Nugroho
Jurnal Epidemiologi Kesehatan Komunitas Vol 2, No 2: Agustus 2017
Publisher : Master of Epidemiology, School of Postgraduate Studies, Diponegoro University, Indonesia

Background: The prevalence of hypertension in type 2 diabetic patients is 1,5-3 times higher than it is in nondiabetic individuals This chronic condition accelerates macrovascular complications. Research about risk factors of hypertension in type 2 diabetic patients is still rare because its causes multifactorial. The objectives of this research is to explain the risk factors affecting hypertension in type 2 diabetic patients.Methods: An observational studies with case-control study design in Primary Healthcare Centers patients in Pati District. Patients with hypertension in type 2 diabetes are the case, while the type 2 diabetes patients without hypertension are the control. There were 57 cases and 57 controls included. Data were obtained from medical records and qualitative interviews. Chi-square test in bivariate and multiple logistic regression in multivariate analysis.Results: Factors that influence hypertension in type 2 diabetic patients were physical activity (OR=6,4; 95% CI: 2,18 - 18,77; p=0,001), diabetes duration ≥ 5 years (OR=5,4; 95% CI: 1,97 - 14,704; p=0,001), and medication adherence (OR=3,6; 95% CI: 1,32 - 9,83; p=0,012). Other risk factors i.e age ≥45 years, male, diet compliance, history of hypertension, smoking, salt consumption, coffee consumption, and sleep duration were not significantly influenced.Conclusion: In this study, physical activity, diabetes duration, and DM medication adherence are risk factors that influence of hypertension in type 2 diabetic patients.

Hubungan Indeks Massa Tubuh dan Tingkat Aktivitas Fisik dengan Kontrol Glikemik Diabetes Melitus Tipe 2 Marisa Gita Putri; Heri Nugroho; Mateus Sakundarno Adi
Jurnal Epidemiologi Kesehatan Komunitas Vol 7, No 1: Februari 2022
Publisher : Master of Epidemiology, School of Postgraduate Studies, Diponegoro University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jekk.v7i1.6791

Background: Diabetes mellitus (DM) type 2 is still a serious health problem in the world. Type 2 DM results from ineffective use of insulin by the body. Most people with type 2 diabetes worldwide are the result of being overweight and lacking physical activity. The purpose of this study was to determine the relationship of body mass index and physical activity with the glycemic control of type 2 DM patients.Methods: This study used an observational study with a cross sectional design conducted at the Panti Wilasa Citarum Hospital in Semarang. The population in this study were outpatients at Panti Wilasa Citarum Hospital with a sample of 74 people. The sampling technique was consecutive sampling. Measurement of glycemic levels with HbA1c, body mass index based on weight and height, and physical activity with the PAR-WHO questionnaire. Data analysis uses the Spearman Rank correlation test. Result: From 74 research respondents found 52.7% of respondents had bad glycemic control. There is a relationship between body mass index and poor glycemic control (p = 0.041). There is no relationship between physical activity and poor glycemic control (p = 0.437).Conclusion: The advice given for respondents is to be able to maintain their diet and increase physical activity by exercising regularly.

FAKTOR RISIKO KEJADIAN NEFROPATI DIABETIKA STADIUM 3-5 Sri Wahyuningsih Roesipin; Heri Nugroho Hario Seno; Suhartono Suhartono; Suharyo Hadisaputro; Mateus Sakundarno
Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal Vol 8 No 2 (2018): Oktober
Publisher : LPPM STIKES KENDAL

Nefropati diabetika merupakan penyebab utama kejadian gagal ginjal. Prevalensi di negara-negara Asia sangat tinggi. Sebanyak 20%-40% penderita diabetes akan berkembang menjadi nefropati diabetika, jika tidak dilakukan pencegahan dengan pengelolaan faktor risikonya. Namun penelitian tentang faktor risiko nefropati diabetika di Indonesia masih jarang dilakukan. Penelitian ini bertujuan untuk mengetahui faktor-faktor risiko tersebut. Desain penelitian ini adalah studi kasus kontrol dengan jumlah sampel 43 kasus dan 43 kontrol. Kasus adalah penderita diabetes dengan komplikasi nefropati diabetika stadium 3-5 dan kontrol adalah penderita diabetes dengan nilai eGFR>60ml/menit/1,73m2 dengan proteinuria negatif. Pengambilan sampel menggunakan teknik consecutive sampling pada pasien diabetes yang dirawat inap. Variabel bebas meliputi riwayat keluarga menderita penyakit vaskuler, lama menderita diabetes, riwayat obesitas, kadar gula darah puasa, kadar kolesterol total, status hipertensi, kebiasaan merokok, status hiperurisemia, kualitas tidur, pola konsumsi obat dan aktifitas fisik. Data diolah secara univariat, bivariat dan multivariat menggunakan regresi logistik berganda. Hasil analisis regresi logistik berganda menunjukkan bahwa yang terbukti merupakan faktor risiko kejadian nefropati diabetika stadium 3-5 adalah hiperurisemia (OR 9,36; 95%CI: 3,035-28,863) dan hipertensi (OR 3,75; 95%CI:1,090-12,934. Hipertensi dan hiperurisemia merupakan faktor yang dapat diperbaiki, sehingga penderita diabetes disarankan untuk mengendalikan tekanan darah dan kadar asam uratnya sedini mungkin utnuk mencegah komplikasi nefropati diabetika. Kata kunci: Nefropati diabetika, Faktor risiko THE RISK FACTORS OF DIABETIC NEPHROPATHY IN STAGE 3-5 ABSTRACT Diabetic nephropathy is a major cause of kidney failure. The prevalence in Asian countries is very high. As many as 20% -40% of diabetics will develop into diabetic nephropathy, if not prevented by managing risk factors. However, research on the risk factors for diabetic nephropathy in Indonesia is still rare. This study aimed to determined the risk factors for diabetic nephropathy. The study design was a case control study with a total sample of 43 cases and 43 controls. The cases were diabetics with stage 3-5 of diabetic nephropathy and the controls were diabetics with eGFR> 60ml / minute / 1.73m2 with negative proteinuria. Sampling used consecutive sampling technique in hospitalized diabetic patients. Independent variables were family history of vascular disease, duration of diabetes, history of obesity, fasting blood sugar levels, total cholesterol levels, hypertension status, smoking habits, hyperuricemia status, sleep quality, medicines consumption patterns and physical activity. Data was processed in univariate, bivariate and multivariate using multiple logistic regression. The results of multiple logistic regression analysis showed that the significant risk factors for stage 3-5 of diabetic nephropathy were hyperuricemia (OR 9.36; 95% CI: 3.035-28.863) and hypertension (OR 3.75; 95% CI: 1.090-12.934). Hypertension and hyperuricemia are modifiable risk factors, so that diabetic patients are advised to control their blood pressure and uric acid levels as soon as possible to prevented the diabetic nephropathy. Keywords: Diabetic nephropathy, risk factors.

Effects of Pancreatic Omentoplasty on Diabetes Mellitus with Obesity after Sleeve Gastrectomy: An In Vivo Study Indra Kusuma Adi Putranto; K. Heri Nugroho; Abdul Mughni
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 10 (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.v6i10.592

Background: DM, especially type 2 diabetes mellitus (DMT2), is closely related to obesity. Insulin resistance and inflammation that occur in obese patients can be treated with SG procedures. Post-SG weight loss can reduce the lipo apoptotic process and can improve the function of pancreas β cells. The omentum is rich in potential mesenchymal stem cells and is rich in anti-inflammatory cytokines, and various growth factors, so the omentoplasty procedure is believed to be able to provide a regenerating effect on the pancreatic tissue so that the performance of the pancreas can be optimal. Methods: An experimental study with 18 rats which were divided into control and treatment groups. The treatments were sleeve gastrectomy and pancreatic omentoplasty. Furthermore, analysis of body weight and levels of IL-10 and HOMA IR was carried out with the help of SPSS software version 25 univariate and bivariate. Results: There was a difference in mean body weight, levels of IL-10, and HOMA IR before and after treatment, p<0.001. Conclusion: Omentoplasty is effective in improving the condition of diabetes mellitus with obesity after sleeve gastrectomy surgery in vivo.

Effects of Pancreatic Omentoplasty on Diabetes Mellitus with Obesity after Sleeve Gastrectomy: An In Vivo Study Indra Kusuma Adi Putranto; K. Heri Nugroho; Abdul Mughni
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 10 (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.v6i10.592

Background: DM, especially type 2 diabetes mellitus (DMT2), is closely related to obesity. Insulin resistance and inflammation that occur in obese patients can be treated with SG procedures. Post-SG weight loss can reduce the lipo apoptotic process and can improve the function of pancreas β cells. The omentum is rich in potential mesenchymal stem cells and is rich in anti-inflammatory cytokines, and various growth factors, so the omentoplasty procedure is believed to be able to provide a regenerating effect on the pancreatic tissue so that the performance of the pancreas can be optimal. Methods: An experimental study with 18 rats which were divided into control and treatment groups. The treatments were sleeve gastrectomy and pancreatic omentoplasty. Furthermore, analysis of body weight and levels of IL-10 and HOMA IR was carried out with the help of SPSS software version 25 univariate and bivariate. Results: There was a difference in mean body weight, levels of IL-10, and HOMA IR before and after treatment, p<0.001. Conclusion: Omentoplasty is effective in improving the condition of diabetes mellitus with obesity after sleeve gastrectomy surgery in vivo.

Karakteristik dan Keluaran Pasien COVID-19 dengan DM di RS Umum Pusat Dr. Kariadi (Tinjauan pasien periode Maret-Juli 2020) Minuljo, Tania Tedjo; Anindita, Yohana Prima Ceria; Seno, Heri Nugroho Hario; Pemayun, Tjokorda Gde Dalem; Sofro, Muchlis Achsan Udji
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 1A (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Pendahuluan Jawa Tengah merupakan propinsi dengan kasus COVID-19 terbanyak ke-4 di Indonesia (lebih dari 8.000 kasus). RS Umum Pusat Dr. Kariadi (RSDK) sebagai RS rujukan memiliki 436 kasus terkonfirmasi COVID-19 per 10 Juli 2020. Diabetes mellitus (DM) diketahui menurunkan sistem imun dan memperburuk reaksi inflamasi. Karakteristik dan keluaran pasien COVID-19 dengan DM di RSDK belum pernah dilaporkan sebelumnya. Metode Data dari rekam medis RSDK. Diagnosis DM: riwayat DM dan/atau GDS >200 mg/dL atau HbA1c >7%. Diagnosis COVID-19: PCR usapan nasofaring-orofaring positif. Karakteristik dasar: usia, jenis kelamin, keluhan, riwayat kontak, riwayat perjalanan, jenis dan tempat perawatan, lama perawatan, komorbid, serta terapi DM. Pemeriksaan penunjang: GDS, HbA1c, kreatinin, saturasi O2, C-reactive protein (CRP), proklasitonin, D-dimer, dan fibrinogen dikelompokkan berdasarkan keluaran (hidup vs. mati); dilakukan uji beda. Analisis dengan SPSS v.24 (IBM, New York, USA). Hasil Pasien COVID-19 dengan DM periode Maret-10 Juli 2020 sebanyak 42 dari total 436 kasus (9,63%). Pria lebih banyak (59,5%). Kasus terbanyak usia >50 tahun (64,3%). Batuk, demam, dan sesak nafas adalah keluhan tersering. Mayoritas pasien menyangkal riwayat kontak ataupun bepergian (>75%). Hampir separuh perlu perawatan intensif sejak awal (40,5%). Komorbid terbanyak hipertensi. Separuh kasus mendapat insulin. Persentase kematian 42,9% (18 dari 42). Rerata kendali glikemik (HbA1c 9,7%) dan saturasi O2 (Sat O2 90%) buruk. Rerata penanda gangguan koagulasi (D-dimer, fibrinogen) dan inflamasi akut (CRP, prokalsitonin) meningkat, berturut-turut 3937,4 ng/mL; 496,1 mg/dL; 16,6 mg/L; 12 ng/mL. Tidak ada beda bermakna antara kelompok hidup dan mati. Kesimpulan Mortalitas dan morbiditas COVID-19 sangat tinggi pada DM. Hampir seluruh pasien mengalami gangguan koagulasi dan inflamasi akut. Kata kunci: COVID-19, DM, RS Kariadi Introduction Central Java province has the 4th largest cases of COVID-19 in Indonesia with more than 8.000 cases. Dr. Kariadi General Hospital (RSDK) is one of the referral hospital with 436 confirmed cases of COVID-19 until July 10th 2020. Diabetes mellitus (DM) known to decreases the immune system and worsens the inflammatory reaction. The characteristics and outcomes of patients with COVID-19 and DM in the RSDK have not been reported yet. Method Data were taken from the RSDK medical record. Diagnosis of DM: history of diabetes and/or RBG >200 mg/dL or HbA1c >7%. Diagnosis of COVID-19 infection: positive PCR from nasopharyngeal-oropharyngeal smear. Baseline characteristics: age, sex, chief complaints, contact and travel history, type and place of care, duration of treatment, comorbidity, and diabetes treatment options. Laboratory result: RBG, HbA1c, creatinine, O2 saturation, C-reactive protein (CRP), proclasitonin, D-dimers, and fibrinogen were grouped according to patient output (life vs. death) and different tests was performed. Data analysis was performed with SPSS v.24 (IBM, New York, USA). Result The number of patients with COVID-19 and DM was 42 out of 436 cases (9.63%). Men was more prevalent (59.5%). Most cases were >50 years of age (64.3%). Cough, fever, and shortness of breath were the most prevalent chief complaints. The majority of patients denied contact or travel history (>75%). Nearly half of the cases needed intensive care (40.5%) at arrival. Hypertension was the no.1 comorbid. Half cases received insulin therapy. Percentage of death was 42.9% (18 out of 42). Average of glycemic control (HbA1c 9.7%) and O2 saturation (Sat O2 90%) were poor. Coagulation (D-dimer, fibrinogen) and acute inflammatory (CRP, procalsitonin) markers were increased, respectively 3937.4 ng/mL; 496.1 mg/dL; 16.6 mg/L; 12 ng/mL. There was no significant difference between the life and death groups. Conclusion Mortality and morbidity of patients with COVID-19 and DM was very high. Almost all patients suffered from disseminated intravascular coagulation (DIC) and severe acute inflammation. Key words: COVID-19, DM, Kariadi Hospital

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