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Association between Thyroid Status and Glucose Intolerance inHyperthyroid Patients Wisnu, Wismandari; Soewondo, Pradana; Subekti, Imam
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 1
Publisher : UI Scholars Hub

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Introduction. The most common endocrinopathy in adults are diabetes mellitus (DM) and thyroid disease. Hyperthyroidism decreases blood glucose control and increased the need of insulin. However, the mechanism of abnormal glucose metabolism in hyperthyroidism is not fully understood. This study aims to determine the relationship of thyroid status with incidence of glucose intolerance in hyperthyroid patients compared to hyperthyroid patients who have achieved clinical status of eutyroid and normal population. Methods. This study was cross sectional design in outpatients with hyperthyroidism in hyperthyroid and euthyroid/subclinical hyperthyroid status, and healthy volunteers who had matching age and sex. An oral glucose test and Homeostatic Model Assesment Insulin Resistance was performed after the diagnosis of hyperthyroidism by FT4 and TSH measurement. Data analysis was performed using SPSS for Windows version 20.0. Results. There were 114 eligible patients (40 case hyperthyroid, 40 case euthyroidism/subclinical hyperthyroidism and 34 healthy subjects). Proportion of glucose intolerance in hyperthyroidism is 52,5% (10% DM, 32,5% impaired glucose tolerance (IGT), and 10% impaired fasting glucose (IFG)), in euthyroidism/subclinical hyperthyroidism was 20% (5% DM, 15% IGT, and 0% IFG), and in healthy subjects was 11,8% (0% DM, 8,8% IGT, and 2,9% IFG). Glucose intolerance in hyperthyroidism was significantly different than euthyroidism/subclinical hyperthyroidism (p=0.002). We also found that the association between thyroid status and glucose intolerance in the group without insulin resistance was significantly different (p=0.004). Conclusions. Our study conclude that there is association between hyperthyroidism and glucose intolerance. Hyperthyroid patients in euthyroidism/subclinical hyperthyroidism status have the same risk as the healthy subject to became glucose intolerance.

Association of Proprotein Convertase Kexin/Type 9 with Atherosclerosis in People with Type 2 Diabetes Mellitus: a Systematic Review Luthfia, Farissa; Wisnu, Wismandari; Tahapary, Dicky Levenus; Nugroho, Pringgodigdo
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 2
Publisher : UI Scholars Hub

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Introduction. Type 2 diabetes melitus is the leading cause of cardiovascular event with high level of low-density lipoprotein as the main predictor marker of atherosclerosis. PCSK9 plays a role in LDL-receptor regulation, its association with atherosclerosis had been investigated but the result is inconsistent. This study aimed to examine the association between PCSK9 level and atherosclerosis in people with type 2 diabetes. Methods. A systematic review was done in July 18 – September 02, 2020 and registered in PROSPERO. Risk of bias of each study was analyzed with Newcastle Ottawa scale tools. Studies involved in this systematic review then narratively analyzed by two independent reviewers. Results. There are 430 subjects involved from 4 studies. Guo, et al. reported that there was a significant association between PCSK9 level with atherosclerosis in type 2 diabetes melitus (OR: 1.12 (CI 95% 1.041 – 1.204), p: 0.002), those association was also reported by Ma, et al. with p value Conclusions. There is still insufficient evidence that show the association between PCSK9 level and atherosclerosis in type 2 DM. Therefore, longitudinal primary research is needed.

HUBUNGAN MELASMA DENGAN WARNA KULIT, PORI, DAN KERUT Irma Bernadette Sihotang , SpKK(K); Yusnita Rahman; Roro Inge Ade Krisanti; Wismandari Wisnu
Media Dermato-Venereologica Indonesiana Vol 49 No 2 (2022): Media Dermato-Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v49i2.332

Melasma merupakan kelainan hiperpigmentasi didapat, umumnya terdapat pada wajah. Manifestasi klinis dari melasma dapat dinilai menggunakan Modified Melasma Area and Severity Index (mMASI). Penentuan lesi melasma juga dapat dilakukan dengan menggunakan alat ukur Janus II facial analysis system. Tujuan penelitian ini untuk mengetahui hubungan antara mMASI dengan warna kulit, pori, dan kerut pada wajah dengan menggunakan Janus II facial analysis system. Penelitian ini bersifat deskriptif dengan desain potong lintang pada subjek berusia 20-50 tahun, dengan lesi melasma pada daerah wajah. Pengukuran derajat keparahan menggunakan skor mMASI dan Janus II facial analysis system. Hubungan antara melasma berdasarkan mMASI dengan warna kulit, pori, dan kerut wajah dinilai dengan korelasi bivariat. Pada penelitian ini, mMASI memiliki korelasi yang lemah terhadap pori (r=0,377) dan kerut (r=0,323) dan keduanya signifikan secara statistik (p=0,008 dan p=0,025 secara berurutan). mMASI memiliki korelasi yang sangat lemah terhadap warna kulit dan tidak signifikan secara statistik (r=0,045, p=0,761) Penilaian melasma dengan skor mMASI memiliki korelasi bermakna terhadap pori dan kerut. Walaupun korelasi lemah, namun hal ini menunjukkan signifikan secara statistik

Prognosis Mortalitas Pasien Tuberkulosis dengan Komorbid Diabetes Melitus Tipe 2: Analisis Kemal Akbar Suryoadji; Ahmad Fauzi; Alifaturrasyid Syafaatullah Ridwan; Abdul Hafiidh Surya Putra; Wismandari Wisnu
Cermin Dunia Kedokteran Vol 52 No 2 (2025): Pediatri
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i2.1248

Introduction: Indonesia ranks 3rd in tuberculosis (TB) cases in the world, and data from the Ministry of Health in 2020 showed that 10%-15% of TB sufferers had diabetes mellitus (DM). TB is one of the important causes of death, and DM affects the immune system which can increase the severity and mortality of the disease. This evidence-based case report was conducted to examine the mortality risk of tuberculosis patients with DM comorbidity. Methods: An article search was conducted to answer research questions based on 3 databases: PubMed, Cochrane, and ScienceDirect with the keywords “((Tuberculosis) AND (DM type 2) AND (Mortality))”. The search was based on inclusion and exclusion criteria and a critical review was conducted according to the guidelines for prognostic studies. Result: Tuberculosis patients with type 2 DM comorbidities have a 1.51 times higher risk of mortality compared to tuberculosis patients without type 2 DM comorbidities. Conclusion: Study by Huangfu, et al, (2019) can be the best choice to answer the clinical question that the risk of death of tuberculosis patients with comorbid DM increases by 1.51 times compared to patients without DM.

EFFECTIVENESS OF ZINC SUPPLEMENTATION FOR TYPE II DIABETES PREVENTION: A SYSTEMATIC REVIEW: EFEKTIVITAS SUPLEMENTASI ZINK UNTUK PENCEGAHAN DIABETES TIPE II: TINJAUAN SISTEMATIS Ridwan, Alifaturrasyid Syafaatullah; Suryoadji, Kemal Akbar; Rycko, Nada Salsabila; Wisnu, Wismandari
BIMIKI (Berkala Ilmiah Mahasiswa Ilmu Keperawatan Indonesia) Vol. 10 No. 2 (2022): Special Issue: 2nd International Student Conference (ISC)
Publisher : Ikatan Lembaga Mahasiswa Ilmu Keperawatan Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53345/bimiki.v10i2.322

Background: The incidence of prediabetes is predicted to continue to increase. Approximately 25% of prediabetes patients develop type 2 diabetes mellitus (T2DM) within 3–5 years. Zinc is known to have a role in the synthesis, storage, secretion, and action of the insulin hormone. Purpose: The aim of the study is to know about the impact of zinc supplementation in type 2 diabetes mellitus (DM) prevention. Methods: A systematic literature search was performed using the PubMed, Cochrane, and EBSCOHost search engines. The inclusion study includes systematic review and metaanalysis of randomized clinical trials study and randomized clinical study, and we only include the research of the last 10 years. Results: Three RCTs were selected from 175 articles to undergo a critical review with a total of 353 patients with a duration of 6-12 months (level of evidence II-III). The incidence of T2DM in the intervention group decreased significantly (OR: 0.37 [95% CI 0.7-0.8]; RR: 0.44; ARR: 14% [95% CI 3.5-24.5%]; NNT: 7.14 [4-29]) in one study. Zinc supplementation significantly reduced Fasting Blood Sugar (FBS) in two studies (mean difference -17.3 and -5.76) and oral glucose tolerance test (OGTT) in one study (MD -22.6). Conclusion: Administration of zinc in prediabetes patients to prevent the development of T2DM still requires further study with a larger sample, longer duration, and control variables by design and statistics.

Health Related Quality of Life and Associated Factors of Inflammatory Bowel Disease Outpatient Unit in Dr. Cipto Mangunkusumo Hospital Afistianto, Muhammad Fikri; Simadibrata, Marcellus; Putranto, Rudi; Abdullah, Murdani; Setiati, Siti; Wisnu, Wismandari; Antono, Dono; Susilo, Adityo
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 2 (2025): VOLUME 26, NUMBER 2, August, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2622025107-113

Background: Inflammatory Bowel Disease (IBD), encompassing ulcerative colitis (UC) and Crohn's disease (CD), is an inflammatory digestive tract condition with unknown causes. Its unpredictable symptoms affect quality of life. In Indonesia, the quality of life of IBD patients remains unreported. Factors such as advanced age, long disease duration, active disease, corticosteroid use, comorbidities, unemployment, and poor sleep quality may reduce quality of life. This study aims to assess the quality of life profile of IBD patients and its associated factors.Methods: This cross-sectional study collected data from October to November 2024 through interviews at the outpatient unit of Dr. Cipto Mangunkusumo Hospital (RSCM). Quality of life was measured using the Inflammatory Bowel Disease Questionnaire 9 (IBDQ-9), and sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Both tools were validated in Indonesian. Eligible participants met inclusion and exclusion criteria. Bivariate and multivariate logistic regression analyses identified factors associated with quality of life.Results: Among 201 participants, 95% reported a good quality of life. Multivariate analysis identified active disease (PR 4.072 [1.133–14.633], p = 0.031) and combination therapy (PR 12.803 [1.423–115.147], p = 0.023) as factors associated with poor quality of life. Age, disease duration, comorbidities, employment status, and sleep quality showed no significant associations.Conclusion: Most IBD patients (95%) in the RSCM outpatient unit reported a good quality of life. Active disease and combination therapy were linked to poorer quality of life.

Prognosis Mortalitas Pasien Tuberkulosis dengan Komorbid Diabetes Melitus Tipe 2: Analisis Suryoadji, Kemal Akbar; Fauzi, Ahmad; Ridwan, Alifaturrasyid Syafaatullah; Putra, Abdul Hafiidh Surya; Wisnu, Wismandari
Cermin Dunia Kedokteran Vol 52 No 2 (2025): Februari 2025
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i2.1248

Introduction: Indonesia ranks 3rd in tuberculosis (TB) cases in the world, and data from the Ministry of Health in 2020 showed that 10%-15% of TB sufferers had diabetes mellitus (DM). TB is one of the important causes of death, and DM affects the immune system which can increase the severity and mortality of the disease. This evidence-based case report was conducted to examine the mortality risk of tuberculosis patients with DM comorbidity. Methods: An article search was conducted to answer research questions based on 3 databases: PubMed, Cochrane, and ScienceDirect with the keywords “((Tuberculosis) AND (DM type 2) AND (Mortality))”. The search was based on inclusion and exclusion criteria and a critical review was conducted according to the guidelines for prognostic studies. Result: Tuberculosis patients with type 2 DM comorbidities have a 1.51 times higher risk of mortality compared to tuberculosis patients without type 2 DM comorbidities. Conclusion: Study by Huangfu, et al, (2019) can be the best choice to answer the clinical question that the risk of death of tuberculosis patients with comorbid DM increases by 1.51 times compared to patients without DM.

Mitigating Hungry Bone Syndrome: Case Reports on Best Practices After Parathyroidectomy Sarah Firdausa; Luki Kusumaningtyas; Dicky L Tahapary; Wismandari Wisnu; Tri Juli Edi Tarigan
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes Vol. 2 No. 2 (2025): InaJEMD Vol. 2, No. 2
Publisher : PP PERKENI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66266/inajemd.v2i2.65

Severe hyperparathyroidism caused by prolonged high levels of parathyroid hormone (PTH) can be managed by removing the gland. One of the critical complications related to parathyroidectomy is hungry bone syndrome (HBS), an emergency morbidity which may be fatal if not promptly and adequately managed. HBS is defined by a rapid and profound decline in serum calcium levels following surgery, as the bones avidly uptake calcium and phosphate in the absence of high PTH levels. It may present as worsened bone pain, carpopedal spasm, severe hypocalcemia, hypophosphatemia, and hypomagnesemia. This report highlights two patients who underwent parathyroidectomy and had different postoperative outcomes for HBS. The first case involves a 19-year-old male who had a history of recurrent fractures and bone pain. In 2019, he got a fracture from a fall, and in 2020, he experienced another fall leading to shoulder dislocation and further fractures. By late 2021, he was diagnosed with severe hyperparathyroidism due to parathyroid adenoma and the gland was removed. Two days post parathyroidectomy, he developed HBS. He was treated with calcium and vitamin D supplementation. Over two years of follow-ups, his bone density and mobility improved significantly. The second case involves a 46-year-old male with uncontrolled hypertension and chronic kidney disease stage 5 on hemodialysis, presenting with bone pain and deformities. This patient had a long-standing history of bone pain and fractures. He underwent a similar surgical intervention for tertiary hyperparathyroidism but did not develop HBS postoperatively. Careful perioperative monitoring of electrolytes, vigorous supplementation of calcium and vitamin D, and the use of antiresorptive therapies before surgery had been employed. These cases underline the variety of postoperative outcomes and the importance of tailored management strategies. Early intervention, appropriate surgical management, and aggressive postoperative supplementation are crucial to prevent and manage HBS in patients with severe hyperparathyroidism. Multidisciplinary approach and the utilization of various imaging modalities and intraoperative PTH monitoring are mandatory in managing such complex cases. Applying these approaches will reduce the risk of HBS while guaranteeing excellent postoperative care for individuals following parathyroidectomy.

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