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All Journal Jurnal Kedokteran Brawijaya Acta Interna : The Journal of Internal Medicine
Khairina, Ana
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Health Professions Medicine & Pharmacology

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Comparison of the Effectiveness of Subcutaneous Insulin Injection between Upper Arm and Abdominal Sites in Type II Diabetes Mellitus Patients with Normal and Above Normal Body Mass Index Khairina, Ana; Ihsan, Mohammad Robikhul; Susanti, Vina Yanti
Acta Interna The Journal of Internal Medicine Vol 11, No 1 (2021): 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.94630

Abstract

Background. Type II Diabetes Mellitus (DM) has high morbidity and mortality. One of DM therapy is insulin. Insulin effectiveness is affected by the injection site and the thickness of the fat in the injection site. Several studies on the effectiveness of insulin injection sites have been conducted, but the results still vary.Objective. To determine the difference in the effectiveness of subcutaneous insulin injections between the upper arm and abdominal sites on changes in capillary glucose levels in type II diabetes mellitus patients with normal and above-normal body mass index (BMI).Methods. The research design used a quasi-experimental repeated measure design. The research subjects were patients diagnosed with type II DM, age ≥ 40 years, hospitalized in the ward of Dr. Sardjito Hospital Yogyakarta. The effectiveness of insulin injection is described by the difference between 2-hours postprandial glucose (2hPPG) minus fasting blood glucose (FBG) (Δ2hPPG-FBG). Δ2hPPG-FBG was taken on the site of the upper arm and abdomen. Patients were classified based on normal and above normal BMI. Statistical analysis was performed using paired T-tests.Result. There were 14 patients with normal BMI and 11 patients with above normal BMI. Paired T-test showed a significant difference in Δ2hPPG-FBG between the upper arm and abdominal sites in normal BMI patients (p=0.028) with a mean of Δ2hPPG-FBG for the upper arm site of 26,14±38.18 mg/dL, and a mean of Δ2hPPG-FBG of the abdominal site -0.64±50,62 mg/dL. Paired T-test showed no significant difference in Δ2hPPG-FBG between the upper arm and abdominal sites in patients with an above-normal BMI (p = 0.239).Conclusion. The effectiveness of subcutaneous insulin injection in the abdominal site was better than in the upper arm site in patients with normal BMI. There was no difference in the effectiveness of subcutaneous insulin injection between the upper arm and abdominal sites in patients with an above-normal BMI.
Clinical Profile and Prognostic Factors of Mortality in Elderly Covid-19 at Ansari Saleh Hospital Agung SNC, Wiwit; Khairina, Ana; Erianty, Erni
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.13

Abstract

Morbidity and mortality of elderly with Covid-19 are higher than in adults. This study aimed to determine the prognostic factors of mortality in elderly with Covid -19. This research was a retrospective cohort study in patients aged 60 years and older with a PCR-confirmed diagnosis of Covid -19 admitted to Ansari Saleh Hospital, South Kalimantan, Indonesia between January to July 2021. Data on age, sex, comorbidities, symptoms, physical examinations, laboratory examinations, chest x-rays, and Covid severity degree were collected, univariate and multivariate analyses performed to determine the independent prognostic factors. The research results showed 209 samples met the criteria. The average age was 66,94 years, dominated by men (57.9%). The most common comorbidities were hypertension (48.8%), diabetes mellitus (35.4%), and chronic heart failure (8.1%). The most frequent symptoms were dyspnea (79.9%), cough (74.2%), and fever (56.5%). Patients treated mostly had severe/critical degree of Covid -19 (140 patients, or 67%). The results of multivariate logistic regression analysis on the variables of respiratory rate (p=0.009; OR=1.1), NLR level (p=0.002; OR=1.081), age (p=0.025; OR=2.479) and Covid severity degree (p=0.008; OR=8.206) showed significant results as independent prognostic factors of mortality. Covid severity degree variable has the highest prognostic level; patients with severe Covid degree have an 8.206 times higher chance of death than mild-to-moderate degrees. In conclusion, respiratory rate, NLR level, age, and Covid severity degree can act as prognostic factors of mortality in elderly suffering from Covid-19.
Clinical Profile and Prognostic Factors of Mortality in Elderly Covid-19 at Ansari Saleh Hospital Agung SNC, Wiwit; Khairina, Ana; Erianty, Erni
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.13

Abstract

Morbidity and mortality of elderly with Covid-19 are higher than in adults. This study aimed to determine the prognostic factors of mortality in elderly with Covid -19. This research was a retrospective cohort study in patients aged 60 years and older with a PCR-confirmed diagnosis of Covid -19 admitted to Ansari Saleh Hospital, South Kalimantan, Indonesia between January to July 2021. Data on age, sex, comorbidities, symptoms, physical examinations, laboratory examinations, chest x-rays, and Covid severity degree were collected, univariate and multivariate analyses performed to determine the independent prognostic factors. The research results showed 209 samples met the criteria. The average age was 66,94 years, dominated by men (57.9%). The most common comorbidities were hypertension (48.8%), diabetes mellitus (35.4%), and chronic heart failure (8.1%). The most frequent symptoms were dyspnea (79.9%), cough (74.2%), and fever (56.5%). Patients treated mostly had severe/critical degree of Covid -19 (140 patients, or 67%). The results of multivariate logistic regression analysis on the variables of respiratory rate (p=0.009; OR=1.1), NLR level (p=0.002; OR=1.081), age (p=0.025; OR=2.479) and Covid severity degree (p=0.008; OR=8.206) showed significant results as independent prognostic factors of mortality. Covid severity degree variable has the highest prognostic level; patients with severe Covid degree have an 8.206 times higher chance of death than mild-to-moderate degrees. In conclusion, respiratory rate, NLR level, age, and Covid severity degree can act as prognostic factors of mortality in elderly suffering from Covid-19.
Co-Authors Erianty, Erni Ihsan, Mohammad Robikhul Susanti, Vina Yanti Wiwit Agung Sri Nur Cahyawati