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Abstract
Background: Based on the International Diabetes Federation, the prevalence of diabetes in 2030 will be around 438 million people. In 2019, type 2 diabetes mellitus caused 4.2 million deaths in the world. Diabetes mellitus is a metabolic disorder that requires long-term therapy. Insulin is one of the therapies for type 2 diabetes mellitus. Parameters for monitoring the success of therapy were plasma glucose levels and Hba1c values.
Objective: This study aimed to compare the values of plasma glucose and glycosylated hemoglobin (Hba1c) in insulin glargine and detemir patients with type 2 diabetes mellitus (DM) at Ulin Regional Public Hospital, Banjarmasin.
Method: This study used a cross-sectional study design in March-May 2022 in 60 patients with type 2 DM at Ulin Regional Public Hospital, Banjarmasin. The data taken was in the form of fasting plasma glucose (FPG), 2-hour post-load plasma glucose (OGTT), and Hba1c values for 12 weeks. Statistical analysis was performed using the Mann-Whitney test with a confidence level of 95%.
Results: The results showed that the average pre-post glargine FPG values were 212-139,6 mg/dL and the pre-post detemir FPG values were 224.6-159.8 mg/dL. Hba1c values in patients using glargine pre-post were 9.1% and 8.3%, and the average Hba1c values on insulin detemir pre-post were 9.28% and 8.29%.
Conclusion: In therapy using insulin glargine compared to detemir, there was no significant difference between KGDP, KGD2PP, and Hba1C (p> 0.05).
Intisari
Latar belakang: Berdasarkan International Diabetes Federation (IDF), prevalensi DM tipe 2 tahun 2030 berkisar 438 juta orang. Pada tahun 2019, DM tipe 2 menyebabkan 4,2 juta kematian di dunia. Diabetes mellitus merupakan penyakit gangguan metabolisme yang membutuhkan terapi jangka panjang, dan insulin merupakan salah satu terapi DM tipe 2. Parameter untuk monitoring keberhasilan terapi dapat dilihat berdasar nilai kadar glukosa darah dan nilai Hba1c.
Tujuan: Membandingkan nilai Kadar Glukosa Darah Puasa (KGDP), Kadar Glukosa Darah 2 jam Post Prandial (KGD2PP), dan Hba1c pada insulin glargine dan insulin detemir pasien DM tipe 2 di Rumah Sakit Umum Daerah (RSUD) Ulin, Banjarmasin.
Metode: Penelitian menggunakan rancangan cross sectional selama bulan Maret-Mei 2022 pada 60 pasien rawat jalan DM tipe 2 di RSUD Ulin Banjarmasin. Data yang diambil berupa nilai KGDP, KGD2PP dan Hba1c selama 12 minggu. Analisis statistik dilakukan menggunakan analisis mann-whitney test dengan tingkat kepercayaan 95%.
Hasil: Hasil penelitian menunjukkan nilai rata-rata nilai KGDP glargine pre-post adalah 212 – 139,6 mg/dL dan nilai KGDP detemir pre-post adalah 224,6 – 159,8 mg/dL. Hba1c pada pasien yang menggunakan glargine pre-post adalah 9,1% dan 8,3% serta rata-rata nilai Hba1c pada insulin detemir pre-post adalah 9,28% dan 8,29%.
Kesimpulan: Terapi menggunakan insulin glargine dibandingkan detemir tidak terdapat perbedaan yang signifikan antara nilai KGDP, KGD2PP, dan Hba1C p>0,05).
Kata kunci: KGDP, KDG2PP, Hba1c, glargine, detemir
Keywords
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
- Capson, J., Cade, K., & Avanesyan, A. (2019). Detemir vs Glargine: Comparison of Inpatient Glycemic Control. Journal of the American Osteopathic Association, 119(2), 89-95. doi: https://doi.org/10.7556/jaoa.2019.014
- Chan, P. D. (2004). Treatment Guidelines for Medicine and Primary Care, 2004 Edition. California: Current Clinical Strategies Publishing.
- Crisher, M. A., Giuliano, C. A., & Hartner, C. L. (2019). Insulin Detemir Versus Insulin Glargine in The hospital: Do Hypoglycemia Rates Differ? Clinical Diabetes, 37(2), 167-171. doi:https://doi.org/10.2337/cd18-0065
- Dipiro, J. T., Talbert, R. L., Yee, G. C., Matzke, G. R., Wells, B. G., & Posey, L. M. (2008). Pharmacotherapy A Pathophysiologic Approach Seventh Edition. United States of America: The McGraw-Hill Companies.
- Heise, T., Nosek, L., Rønn, B. B., Endahl, L., Heinemann, L., Kapitza, C., & Draeger, E. (2004). Lower Within-Subject Variability of Insulin Detemir in Comparison to NPH Insulin and Insulin Glargine in People With Type 1 Diabetes. Diabetes, 53(6), 1614-1620. doi:https://doi.org/10.2337/diabetes.53.6.1614
- Lepore, M., Pampanelli, S., Fanelli, C., Porcellati, F., Bartocci, L., Di Vincenzo, A., Cordoni, C., Costa, E., Brunetti, P., & Bolli, G. B. (2000). Pharmacokinetics and Pharmacodynamics of Subcutaneous Injection of Long-Acting Human Insulin Analog Glargine, NPH Insulin, and Ultralente Human Insulin and Continuous Subcutaneous Infusion of Insulin Lispro. Diabetes, 49(12), 2142-2148. doi:https://doi.org/10.2337/diabetes.49.12.2142
- Marathe, P. H., Gao, H. X., & Close, K. L. (2017). American D iabetes A ssociation S tandards of M edical C are in Diabetes 2017. 9(4), 320-324. doi:https://doi.org/10.1111/1753-0407.12524
- Perkeni. (2019). Pedoman Terapi Insulin pada Pasien Diabetes Melitus 2019. PB Perkeni.
- Plank, J., Bodenlenz, M., Sinner, F., Magnes, C., Gorzer, E., Regittnig, W., Endahl, L. A., Draeger, E., Zdravkovic, M., & Pieber, T. R. (2005). A double-blind, Randomized, Ddose-response Study Investigating The Pharmacodynamic and Pharmacokinetic Properties of The Long-acting Insulin Analog Detemir. Diabetes care, 28, 1107-1112.
- Poon, K., & King, A. B. (2010). Glargine and Detemir: Safety and Efficacy Profiles of The Long-acting Basal Insulin Analogs. Drug, healthcare and patient safety, 2, 213-223. doi:https://doi.org/10.2147/DHPS.S7301
- Silva, T. B., Almeida, P. H., Araújo, V. E., Acurcio, F. d. A., Guerra Junior, A. A., Godman, B., & Alvares, J. (2018). Effectiveness and Safety of Insulin Glargine Versus Detemir Analysis in Patients with Type 1 Diabetes: Systematic Review and Meta-Analysis. Therapeutic advances in endocrinology and metabolism, 9(8), 241-254. doi:https://doi.org/10.1177/2042018818781414
- Swinnen, S. G., Hoekstra, J. B., & DeVries, J. H. (2009). Insulin Therapy for Type 2 Diabetes. Diabetes care, 32(Suppl 2), S253-259. doi:https://doi.org/10.2337/dc09-s318
- Swinnen, S. G., Simon, A. C., Holleman, F., Hoekstra, J. B., & DeVries, J. H. (2011). Insulin Detemir Versus Insulin Glargine for Type 2 Diabetes Mellitus. Cochrane Database of Systematic Reviews, 7. doi:https://doi.org/10.1002/14651858.CD006383.pub2
References
Capson, J., Cade, K., & Avanesyan, A. (2019). Detemir vs Glargine: Comparison of Inpatient Glycemic Control. Journal of the American Osteopathic Association, 119(2), 89-95. doi: https://doi.org/10.7556/jaoa.2019.014
Chan, P. D. (2004). Treatment Guidelines for Medicine and Primary Care, 2004 Edition. California: Current Clinical Strategies Publishing.
Crisher, M. A., Giuliano, C. A., & Hartner, C. L. (2019). Insulin Detemir Versus Insulin Glargine in The hospital: Do Hypoglycemia Rates Differ? Clinical Diabetes, 37(2), 167-171. doi:https://doi.org/10.2337/cd18-0065
Dipiro, J. T., Talbert, R. L., Yee, G. C., Matzke, G. R., Wells, B. G., & Posey, L. M. (2008). Pharmacotherapy A Pathophysiologic Approach Seventh Edition. United States of America: The McGraw-Hill Companies.
Heise, T., Nosek, L., Rønn, B. B., Endahl, L., Heinemann, L., Kapitza, C., & Draeger, E. (2004). Lower Within-Subject Variability of Insulin Detemir in Comparison to NPH Insulin and Insulin Glargine in People With Type 1 Diabetes. Diabetes, 53(6), 1614-1620. doi:https://doi.org/10.2337/diabetes.53.6.1614
Lepore, M., Pampanelli, S., Fanelli, C., Porcellati, F., Bartocci, L., Di Vincenzo, A., Cordoni, C., Costa, E., Brunetti, P., & Bolli, G. B. (2000). Pharmacokinetics and Pharmacodynamics of Subcutaneous Injection of Long-Acting Human Insulin Analog Glargine, NPH Insulin, and Ultralente Human Insulin and Continuous Subcutaneous Infusion of Insulin Lispro. Diabetes, 49(12), 2142-2148. doi:https://doi.org/10.2337/diabetes.49.12.2142
Marathe, P. H., Gao, H. X., & Close, K. L. (2017). American D iabetes A ssociation S tandards of M edical C are in Diabetes 2017. 9(4), 320-324. doi:https://doi.org/10.1111/1753-0407.12524
Perkeni. (2019). Pedoman Terapi Insulin pada Pasien Diabetes Melitus 2019. PB Perkeni.
Plank, J., Bodenlenz, M., Sinner, F., Magnes, C., Gorzer, E., Regittnig, W., Endahl, L. A., Draeger, E., Zdravkovic, M., & Pieber, T. R. (2005). A double-blind, Randomized, Ddose-response Study Investigating The Pharmacodynamic and Pharmacokinetic Properties of The Long-acting Insulin Analog Detemir. Diabetes care, 28, 1107-1112.
Poon, K., & King, A. B. (2010). Glargine and Detemir: Safety and Efficacy Profiles of The Long-acting Basal Insulin Analogs. Drug, healthcare and patient safety, 2, 213-223. doi:https://doi.org/10.2147/DHPS.S7301
Silva, T. B., Almeida, P. H., Araújo, V. E., Acurcio, F. d. A., Guerra Junior, A. A., Godman, B., & Alvares, J. (2018). Effectiveness and Safety of Insulin Glargine Versus Detemir Analysis in Patients with Type 1 Diabetes: Systematic Review and Meta-Analysis. Therapeutic advances in endocrinology and metabolism, 9(8), 241-254. doi:https://doi.org/10.1177/2042018818781414
Swinnen, S. G., Hoekstra, J. B., & DeVries, J. H. (2009). Insulin Therapy for Type 2 Diabetes. Diabetes care, 32(Suppl 2), S253-259. doi:https://doi.org/10.2337/dc09-s318
Swinnen, S. G., Simon, A. C., Holleman, F., Hoekstra, J. B., & DeVries, J. H. (2011). Insulin Detemir Versus Insulin Glargine for Type 2 Diabetes Mellitus. Cochrane Database of Systematic Reviews, 7. doi:https://doi.org/10.1002/14651858.CD006383.pub2