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All Journal Jurnal Kedokteran Brawijaya Majalah Kesehatan FKUB Journal of Islamic Medicine CRJIM (Clinical and Research Journal in Internal Medicine) Jurnal Penyakit Dalam Indonesia
Sasiarini, Laksmi
Fakultas Kedokteran Universitas Brawijaya
Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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PERAN EDUKASI GAYA HIDUP TERHADAP STATUS GIZI, STATUS FUNGSIONAL, DAN KUALITAS HIDUP PASIEN DIABETES MELLITUS TIPE 2 LANJUT USIA Sasiarini, Laksmi; Puspitasari, Ika A; Sunarti, Sri
Majalah Kesehatan FKUB Vol 5, No 1 (2018): Majalah Kesehatan Fakultas Kedokteran
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (269.551 KB) | DOI: 10.21776/ub.majalahkesehatan.005.01.6

Abstract

ABSTRAKIntervensi latihan fisik dan saran diet tinggi protein membantu memperlambat penurunan massa otot, sehingga secara tidak langsung dapat juga memperbaiki status gizi, status fungsional, dan kualitas hidup pada lansia penderita Diabetes Mellitus tipe 2. Penelitian bertujuan apakah terdapat perbedaan status gizi, status fungsional, dan kualitas hidup pada lansia penderita Diabetes Melitus tipe 2 sebelum dan sesudah pemberian latihan fisik dan saran diet tinggi protein. Penelitian eksperimental analitik dengan kohort selama10 minggu. Subjek adalah 56 pasien Diabetes Mellitus tipe 2 di Poli Endokrin RSSA Malang yang 58% adalah wanita dengan rerata usia 65,79±5,74 tahun, penilaian rerata status gizi menunjukkan hasil normal, rerata status fungsional berdasarkan Indeks Barthel menunjukkan ketergantungan ringan, dan rerata kualitas hidup berdasarkan SF 36 menunjukkan nilai yang bagus. Kemudian, subyek dibagi secara acak menjadi 2 kelompok (kelompok perlakuan dan tidak mendapat perlakuan). Analisis data menggunakan uji Independent T Test, Mann Whitney U, dan uji T-Test berpasangan dengan program SPSS for window versi 16.0. Pada kelompok perlakuan, edukasi tentang latihan fisik dan diet tinggi protein didapatkan hasil yang signifikan untuk status gizi, status fungsional, dan kualitas hidup  dibandingkan kelompok kontrol ( p<0,05). Didapatkan juga hasil yang signifikan pada kelompok perlakuan untuk status gizi, status fungsional, dan kualitas hidup sebelum dan sesudah intervensi ( p<0,05).  Kesimpulan dari penelitian ini adalah status gizi, status fungsional, dan kualitas hidup pada lansia penderita diabetes mellitus tipe 2 berbeda secara bermakna antara kelompok kontrol dan kelompok perlakuan, serta terdapat peningkatan status gizi, status fungsional, dan kualitas hidup sebelum dan sesudah intervensi pada kelompok perlakuan. Kata kunci : Lansia penderita Diabetes Mellitus tipe 2, Status Gizi, Status Fungsional, Kualitas Hidup, Latihan Fisik, Diet Tinggi Protein.
HUBUNGAN ANTARA LAMA SAKIT DENGAN STATUS ANTROPOMETRI PASIEN DM TIPE 2 RAWAT JALAN DI RSUD DR. SAIFUL ANWAR MALANG Sasiarini, Laksmi; Andarini, Sri; Sasongko, Ardi
Majalah Kesehatan FKUB Vol 5, No 1 (2018): Majalah Kesehatan Fakultas Kedokteran
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (376.087 KB) | DOI: 10.21776/ub.majalahkesehatan.005.01.7

Abstract

Diabetes Mellitus merupakan masalah kesehatan yang sering ditemukan saat ini di dunia.Diabetes Mellitus tipe 2 memiliki gejala khas dengan terjadinya penurunan berat badan dan status antropometri pada awal menderita yang dapat mengganggu kualitas hidup penderitanya.Penelitian ini bertujuan untuk mengetahui hubungan antara lama menderita Diabetes Mellitus tipe 2 dengan status antropometri. Penelitian ini adalah penelitian observational dan pengambilan data dilakukan dengan metode cross sectional. Pengukuran dan pencatatan data di lakukan secara manual dan di uji korelasi dengan menggunakan teori pearson correlation adalah penderita Diabetes Mellitus tipe 2 yang sedang rawat jalan di Poli Endokrin RSUD dr Saiful Anwar Malang periode Februari-Maret 2014. Selama penelitian di dapatkan 100 sample penderita Diabetes Mellitus tipe 2 dengan 58% subyek wanita dan 42% subyek pria, serta rentang usia 29-90 tahun. Hasil penelitian ini di dapatkan rata-rata usia pasien ± 59.11 tahun, rata–rata BMI ± 24.75 kg/m2, dan rata-rata lingkar pinggang ± 92.46 cm. Hasil yang di dapat dari penelitian ini bisa diambil kesimpulan bahwa lama menderita Diabetes Mellitus tipe 2 tidak memiliki hubungan dengan status antropometri (p > 0.05). Kata kunci : Diabetes Mellitus, antropometri, lama menderita
Keterlambatan Diagnosis Diabetes Mellitus pada Kehamilan Brahmantyo, Herwindo Pudjo; Nurshanty, Ade; Sasiarini, Laksmi
Jurnal Kedokteran Brawijaya Vol 29, No. 3 (2017)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2017.029.03.18

Abstract

Prevalensi wanita dengan diagnosis Diabetes Mellitus (DM) meningkat sepanjang tahunnya termasuk dalam kehamilan. Kami laporkan kasus seorang wanita 36 tahun dengan persalinan anak pertama yang dikonsultasikan dengan peningkatan gula darah sesudah persalinan. Dari hasil anamnesa dan pemeriksaan fisik tidak didapatkan riwayat DM pada pasien dan keluarga yang dapat menjadi penyebab keterlambatan diagnosis DM pada kehamilan. Anamnesis, observasi dan hasil pemeriksaan laboratorium mengindikasikan potensi DM yang dimulai sebelum kehamilan namun tidak dikonfirmasi melalui skrining pemeriksaan gula darah pada kehamilan. Bayi yang dilahirkan mempunyai berat badan normal namun sempat mengalami hipoglikemia. Pasien diberikan terapi injeksi insulin basal dimulai pada dosis 6 iu dan dinaikkan bertahap menjadi 8 iu dan 10 iu, sesuai dengan hasil evaluasi hingga tujuan terapi tercapai. Kasus ini menunjukkan pentingnya penggalian riwayat dengan teliti dan skrining DM dalam kehamilan pada mereka yang berisiko untuk mencegah komplikasi pada janin maupun ibu. Kata Kunci: Diabetes mellitus, kehamilan, komplikasi 
Correlation between Risk Stratification of Complications and Types of Antihyperglycemia Drugs with Incidence of Acute Diabetic Complications in Patients with Diabetes Mellitus during Ramadan Fasting Sasiarini, Laksmi; Simatupang, Charisma Dian; Arsana, Putu Moda
Clinical and Research Journal in Internal Medicine Vol 1, No 2 (2020): New: The Second Issue is Coming!
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.02.3

Abstract

Ramadan fasting for Diabetes Mellitus (DM) patients can lead to acute complications such as hypoglycemia, hyperglycemia, diabetic ketoacidosis (DKA) and thrombosis. Risk stratification predicts fasting safety of DM patients. Dose and timing of antihyperglycemia drugs adjusted during Ramadan fasting. Aim: To know the correlation between the risk stratification of Ramadan fasting and type of antihyperglycemia drugs with the incidence of acute complications in DM patients undergoing Ramadan fasting. Methods: DM patients in Endocrinology Clinic, dr. Saiful Anwar, General Hospital Malang who intend to fast during Ramadan classified in IDF-DAR risk stratification, conduct blood glucose monitoring and filled out a daily logbook during fasting. Results: Thirty-seven subjects were included in the study, only 1 patient with type-1 DM. Average fasting time is 18 days. Acute complications found higher in very high-risk group (5/6) compared to mild/moderate (2/13) and high-risk group (7/18) (p=0.009). Acute complications found higher in group with OAD and insulin combination regiment (2/4) compared to OAD (9/24) or insulin group (3/9) (p= 0. 731). One subject in very high-risk group suffered from acute coronary syndrome. Relationship between risk stratification and the incidence of hypoglycemia (p=0.040) and hyperglycemia (p=0.031) was significant. Relative risk in the very high-risk group was 2.538 compared to mild/moderate risk RR (95% CI)= 0.77 (0.62-0.96). Conclusions: There is a correlations between risk stratification and acute complications in DM patients undergoing Ramadan fasting. No relationship between type of antihyperglycemia drugs with acute complications of Ramadan fasting.
The Impact of Subchronic Soybean Milk and Genistein Supplementation on Pancreatic Fatty Infiltrations of Sprague Dawley Male Mice Sasiarini, Laksmi; Soeatmadji, Djoko Wahono; Santoso, Aktaruddin Arief
Clinical and Research Journal in Internal Medicine Vol 1, No 2 (2020): New: The Second Issue is Coming!
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.02.4

Abstract

Isoflavones (genistein, daidzein) on soybean milk have phytoestrogenic properties. In Asia, the blood phytoestrogen levels can reach 160 ng/ml (80 times higher than Western). This may potentially disrupt endocrine functions regarding its binding with estrogen receptors.. Since the function and distribution of adipose tissues are regulated by estrogen receptors, the reduction of estrogen receptor-α(ERα) results in ectopic fats distribution around visceral tissues, such as the pancreas. Aim: To investigate the impact of subchronic soybean milk and genistein supplementation on pancreatic fatty infiltrations in mice. Methods: The experiment used 35 Sprague dawley male mice under 7 treatment groups within 60 days: negative control with standard rationed food, 3 groups with a variable dose of soybean milk: 100 mg, 200 mg, and 400 mg, and 3 groups with a variable dose of genistein: 0.4 mg, 0.8 mg, and 1.6 mg. Histological measurements on the level of pancreatic fatty infiltrations were conducted after. Analyses used Kruskal-Wallis and post-hoc Mann-Whitney. Results: Medium to a high level of pancreatic fatty infiltrations were found at the control group while there is a decreasing trend on the level of pancreatic fatty infiltrations on groups with soybean milk and subchronic genistein compared with the control group, proportional to higher dosage supplementation. The reduction of pancreatic fatty infiltration levels on groups with soybean milk and subchronic genistein supplementation is not statistically significant compared to control. Conclusion:  Supplementation of soybean milk and subchronic genistein do not significantly reduce the levels of pancreatic fatty infiltrations in Sprague dawley male mice.
Comparison of Diagnostic Value between Point of Care Testing (POCT) and Standardize HbA1c Testing in Primary Health Care Rudijanto, Achmad; Rosandi, Rulli; Sasiarini, Laksmi
Clinical and Research Journal in Internal Medicine Vol 1, No 2 (2020): New: The Second Issue is Coming!
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.02.2

Abstract

Diabetes Mellitus is one of the biggest health problems. HbA1c is used to diagnose, to monitor treatment and treatment adjustment. High Performance Liquid Chromatography (HPLC) and electron spray mass spectrometry are recommended to measure HbA1c. But both methods need expensive cost, facility, and potentially increase health cost burden. HbA1c measurement using Point of Care Testing (POCT) is developed in Indonesia. POCT is more comfortable, has lower cost and easily brought to primary health care. Aim: to assess the clinical efficacy of POCT compared with a standard examination by HPLC. Methods: It is a cross-sectional observational study conducted at a first-level health facility (FKTP) in Malang. The subject population was patients who went to an outpatient unit in FKTP with inclusion criteria aged 20-75 years, were participants in the chronic disease management program (PROLANIS), both diabetes and non-diabetes. Results: Three hundred and thirty eight subjects were participated in this study. Five subjects were excluded because the presence of anemia. We used Wilcoxon test to compare HbA1c level between two methods and Rank Spearman correlation test to find correlation between two methods. This study showed measurement HbA1c level using POCT method had good accuracy (>80%). Other than diagnosis value, increased utilization of POCT HbA1c might also be caused by its portability and patient’s comfort. Conclusions: This study showed a strong correlation (R=0.016) between POCT HbA1c and standardized measurement. POCT HbA1c also showed good accuracy in all HbA1c groups.
Hiperglikemia pada Pasien Diabetes Melitus Tipe 1 dan 2 yang Menjalani Puasa Ramadan : Laporan Kasus Iwal Reza Ahdi; Laksmi Sasiarini
Journal of Islamic Medicine Vol 6, No 1 (2022): JOURNAL OF ISLAMIC MEDICINE EDISI MARET 2022
Publisher : Faculty of Medicine and Health Science, Universitas Islam Negeri Maulana Malik Ibrahim

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18860/jim.v6i1.13741

Abstract

Background: Ramadan fasting is an obligation for every Muslim, including Muslim patients who suffer from diabetes mellitus. The most common complication in diabetic patients when fasting is hypoglycemia, but in special conditions, hyperglycemia can also occur, and even emergency occurs in both type 1 and type 2 diabetes patients. Purpose: To know the hyperglycemia complications in type 1 and 2 diabetes mellitus in Ramadhan fasting Methods: Reported a case of inpatient diabetes mellitus 1 and 2 who underwent fasting during Ramadan and complications of hyperglycemia occurred in dr. Saiful Anwar Hospital (RSSA) Malang during the month of Ramadan Results: Both patients experienced hyperglycemia which was a response to an increase in response to hypoinsulinemia in type 1 diabetes and an increase in glycogenolysis in DM type 2. Conclusion: Hyperglycemia can occur in patients with type 1 and 2 DM who fast during the month of Ramadan
Cardiovascular Rehabilitation in Patients with Diabetes Mellitus Novita Lavi; Cholid Tjahjono; Laksmi Sasiarini
Clinical and Research Journal in Internal Medicine Vol. 3 No. 2 (2022): November 2022
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2022.003.02.7

Abstract

A hazard to global health is being posed by diabetes mellitus (DM). Macrovascular and microvascular abnormalities in blood vessels are one type of DM complication that might happen. In most cases, blood arteries, the brain, and the heart are affected by macrovascular problems. Obesity is well-known to have a substantial significant risk factor for coronary heart disease on its own (CHD). As a result, many persons with DM have a 2 to 4 times higher risk of dying from CHD than those without DM. In fact, different goal parameters (such glucose management, blood pressure, cholesterol status, or body composition) can improve with exercise training to varying degrees in each patient; here is where cardiovascular rehabilitation can help. To attain the best results, the type and intensity of exercise training must be tailored to the unique characteristics of each patient. The clinician's challenge is to teach the patient the skills necessary to maintain lifestyle modifications and to explain the relationship between exercise and blood sugar, BG goal ranges, and the types and amounts of activity that can be done safely.
Correlation of Ramadan Fasting with HbA1C and Lipid ProfileLevel Changes in The Risk Stratification of Complications inDiabetes Mellitus Patients Bramantya, Rinadhi Reza; Arsana, Putu Moda; Sasiarini, Laksmi
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. Diabetic patients will still do Ramadan fasting, which could affect the levels of HbA1C and lipid change after Ramadan. This study aimed to identify the correlation between fasting of Ramadan risk stratification with HbA1C and lipid levels diabetic patients who run the fast of Ramadan. Methods. This was a survey research using pre - post test. Study was conducted among diabetes patients who meet the criteria: carry out routine controls before and after Ramadan fasting at dr. Saiful Anwar Malang Hospital, filling in the required data, and underwent examination laboratory. Patients were grouped into moderate, high, and very high-risk stratification. Then we analyzed the HbA1C and fat levels before (pre) and after (post) Ramadan fasting in each risk group. Results. There were 25 subjects included in this study. There was a decrease in HbA1C level in all subjects from 7.93% (SD 2.3) to 7.86% (SD 1.9) after Ramadan fasting (p = 0.563), only the moderate risk group increased by 0,37% (SB 0.27). In all subjects, total cholesterol levels increased from 196.4 (SD 48.7) mg/dl to 205.0 (SB 70.8) mg/dl (p = 0.397), with the highest change found in the very high-risk group with an increase 30,7 (SD 125.0) mg/dl. There was a decrease in HDL levels from 55.6 (SD 31.3) mg/dl to 47.8 (SD 10.5) mg/dl (p = 0.782), and the highest decrease occurred in the very high - risk group (27.7 (SD 66,9) mg / dl). There was an increase in the LDL from 115.9 (SD 45.8) mg/dl to 130.4 (SD 41.9) mg/dl (p = 0.133) which the highest increase found in the very high-risk group (55.0 (SD 74.7) mg/dl). Only triglycerides showed an improvement from 190.7 (SD 105.2) mg/dl to 188.8 (SD 79.6) mg/dl (p = 0.084), increasement only occur in the high risk group (13.2 (SD 213.4) mg/dl). Conclusion. There was a decrease in HbA1C levels, but the value of the statistics was not significant. There was a negative effect of fasting Ramadan against blood-fat levels, except for improvements in the levels of triglycerides though statistically not significant
A Case Series Hemichorea-Hemiballism Syndrome Related toNonketotic Hyperglycemia: A Challenge to Diagnostic Process Sasiarini, Laksmi; Budianto, Rahmad; Tarigan, Ricky C.
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
Publisher : UI Scholars Hub

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Abstract

Diabetes mellitus is quite familiar to health-care personnel but occasionally presents with unusual manifestations. One of them is hemichorea-hemiballismus syndrome, a spectrum of involuntary, continuous non-patterned movement involving one side of the body which is related to nonketotic hyperglycemia in uncontrolled diabetes. Here we present two cases of nonketotic hyperglycemic diabetic patients who presented with the hemichorea-hemiballismus syndrome. First – a 57 years old woman was presented with involuntary, arrhythmic, and repetitive movement on the right arm and leg, accompanied by twitching on the right face for two weeks. She had an uncontrolled history of diabetes mellitus. The second- a 60 years old man was presented with recurrent general tonic-clonic seizure for about four days. The history of diabetes was unknown. Initial diagnosis on admission was general tonic-clonic seizure due to thrombotic cerebrovascular accident (CVA). Intravenous diazepam did not give any response to the seizures. Their brain CT scan imaging showed non-enhancing hyperdensities in the basal ganglia due to non-ketotic hyperglycemia, but the lesion was more extensive on the second patient. An involuntary movement was resolved after achieving blood glucose target by rehydration and continuous intravenous insulin therapy. Clinical response in these cases were reversible while the hyperdensities lesion will be persistent for a few months.
Co-Authors Achmad Rudijanto Ahdi, Iwal Reza Arsana, Putu Moda Bayu Eka Nugraha Brahmantyo, Herwindo Pudjo Bramantya, Rinadhi Reza Budianto, Rahmad Cholid Tjahjono Djoko Wahono Soeatmadji Iwal Reza Ahdi Novita Lavi Nugraha, Bayu Eka Nurshanty, Ade Puspitasari, Ika A Putu Moda Arsana Putu Moda Arsana Rahmad Budianto Ricky C. Tarigan Rinadhi Reza Bramantya Rulli Rosandi Santoso, Aktaruddin Arief Sasongko, Ardi Simatupang, Charisma Dian Sri Andarini Sri Sunarti Tarigan, Ricky C.