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The Effect of Telmisartan and Metformin on Insulin Resistance in Metabolic Syndrome Patients with Insulin Therapy oktariani, Siswi; Pramono, Raden Bowo; Sinorita, Hemi
Acta Interna The JOurnal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Acta Interna The JOurnal of Internal Medicine

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Abstract

ABSTRACTBackground: Recommendations for therapy insulin resistance are metformin and thiazolidindion. Sideeffects of thiazolidindion due to peripheral edema occurs to 2-5% and increased 5-15% when combinedwith insulin therapy. Telmisartan, an angiotensin receptor blocker, has anti-hypertensive effects and improveinsulin resistance. Telmisartan effect on peroxisome proliferator activated receptor γ agonist and has the samestructure of the group thiazolidindion, pioglitazone. The research objective was to determine the effectsof telmisartan and metformin on insulin resistance in metabolic syndrome patients with insulin therapy.Methods: This study used a before-after design. The study was conducted in the internal medicine clinic of theendocrinology department of Dr. Sardjito Hospital Yogyakarta. Subjects were patients who met the diagnosis of metabolic syndrome based on the IDF 2005, hypertension and received insulin therapy. Subjects given metforminand telmisartan therapy for 12 weeks. Subjects examined HOMA IR before and after treatment. The averagedecrease in HOMA IR was tested by paired t-test or Wilcoxon test. P value <0.05 was considered signifi cant.Result: The total sample were 27 subjects. Data analysis was performed on 11 subjects. Fasting bloodglucose before and after treatment was signifi cantly decreased (p<0.001) whereas the fasting insulin levelsincreased. HOMA IR was signifi cantly decreased after treatment {p = 0.004 (5.79 – 20.26), CI 95%}.Conclusion: this study found insulin resistance decreased signifi cantly in patients with the metabolicsyndrome of insulin therapy who received metformin and telmisartan.Keywords : metabolic syndrome, insulin therapy, metformin, telmisartan, HOMA IR
The Effect of Telmisartan and Metformin on Insulin Resistance in Metabolic Syndrome Patients with Insulin Therapy Pramono, Raden Bowo; Oktariani, Siswi; Sinorita, Hemi
Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (177.968 KB)

Abstract

ABSTRACTBackground: Recommendations for therapy insulin resistance are metformin and thiazolidindion. Side effects of thiazolidindion due to peripheral edema occurs to 2-5% and increased 5-15% when combined with insulin therapy. Telmisartan, an angiotensin receptor blocker, has anti-hypertensive effects and improve insulin resistance. Telmisartan effect on peroxisome proliferator activated receptor γ agonist and has the same structure of the group thiazolidindion, pioglitazone. The research objective was to determine the effects of telmisartan and metformin on insulin resistance in metabolic syndrome patients with insulin therapy.Methods: This study used a before-after design. The study was conducted in the internal medicine clinic of the endocrinology department of Dr. Sardjito Hospital Yogyakarta. Subjects were patients who met the diagnosis of metabolic syndrome based on the IDF 2005, hypertension and receive insulin therapy. Subjects given metformin and telmisartan therapy for 12 weeks. Subjects examined HOMA IR before and after treatment. The average decrease in HOMA IR was tested by paired t test or Wilcoxon test. P value <0.05 was considered signifi cant.Result: The total sample were 27 subjects. Data analysis was performed on 11 subjects. Fasting blood glucose before and after treatment was signifi cantly decreased (p<0.001) whereas the fasting insulin levels increased. HOMA IR was signifi cantly decreased after treatment {p = 0.004 (5.79 – 20.26), CI 95%}.Conclusion: this study found insulin resistance decreased signifi cantly in patients with the metabolic syndrome of insulin therapy who received metformin and telmisartan.Keywords : metabolic syndrome, insulin therapy, metformin, telmisartan, HOMA IR
Dukungan keluarga dan jadwal makan dan sebelum edukasi berhubungan dengan kepatuhan jadwal makan pasien diabetes melitus (DM) tipe 2 rawat jalan yang mendapat konseling gizi di RSUD Kota Yogyakarta Purba, Martalena Br; Rahayu, Endah Sri; Sinorita, Hemi
Jurnal Gizi Klinik Indonesia Vol 7, No 2 (2010): November
Publisher : Minat S2 Gizi dan Kesehatan, Prodi S2 IKM, FK-KMK UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (232.733 KB) | DOI: 10.22146/ijcn.17739

Abstract

Background: Diabetes mellitus (DM) is a clinical syndrome with symptoms of hyperglycemia, urinary glucose excretion and disorder of insulin mechanism. Approximately 90-95% of diabetic patients suffer from type 2 DM. Various studies show that compliance to treatment of chronic disease in general is low. Compliance to eating or food frequency amongst DM patients in hospital in particular is very low. The success of self management of blood glucose (SMBG) needs participation of the patient, families, and educator team.Objective: To study the factors affecting eating compliance particularly eating schedule among type 2 diabetic out-patient who had nutrition counseling in RSUD Kota Yogyakarta.Method: It was an observasional study with cross sectional design and purposive sampling. Data collection was done in October 2008 with 98 subjects. The sampel were type 2 diabetic out-patients according to inclusion criteria at out- patient clinic in RSUD Kota Yogyakarta. Statistical test with 95% confidence interval was applied to investigate factors infuenced eating compliance.Results: There were no correlations between eating compliance and disease duration (RP=  1,253 and p =0,403), and also with type of occupation (RP= 1,047 dan p= 1,000). However, it was found that family support affected eating compliance (RP= 1,723 dan p= 0,025) as well as eating schedule before nutrition counseling (RP = 2,151 and p= 0,02).Conclusion: Duration of disease and type of occupation did not affect eating compliance. Nevertheless, family support and eating schedule before nutrition education affected eating compliance among type 2 DM out-patients in RSUD Kota Yogyakarta.
Low level of plasma VEGF-A and C allele of -2578*C/A polymorphism in the VEGF-A gene are risk factors of diabetic foot ulcer in Javanese ethnic Rahayu, Ika; Sinorita, Hemi; Timotius, Kris Herawan; Sadewa, Ahmad Hamim
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 2 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (337.404 KB) | DOI: 10.19106/JMedSci005302202106

Abstract

Diabetes mellitus (DM) is caused by abnormal insulin secretion, impairedinsulin action, or both. Approximately 12-25% of type 2 diabetes mellitus(T2DM) patients will develop diabetic foot ulcers (DFU). Vascular endothelialgrowth factor (VEGF) is a group of platelet-derived growth factors (PDGF)which have a potential role in angiogenesis. Low levels of VEGF-A can causeinsufficient angiogenesis leading to wound healing inhibition. The 2578*C/Apolymorphism of VEGF-A gene has been reported as a candidate markerfor the DFU development. However, the variant role in the development ofDFU in Javanese ethnic needs to be clarified. This study was conducted tocompare VEGF-A levels and the -2578*C/A polymorphism of the VEGF geneamong diabetic patients with and without DFU in Javanese ethnic. In thiscase-control study, the T2DM individuals with DFU as case group (n=19) andwithout DFU as control group (n=41) were recruited. The VEGF-A levelsweredetermined by ELISA. The ARMS-PCR technique was applied to investigate thepresence of -2578*C/A polymorphism of the VEGF gene. Data were analyzedwith independent t, Mann-Whitney, Chi-square, and Kruskal-Wallis tests withsignificance level of p<0.05. The median of plasma VEGF-A level was significantlydifferent between case and control groups (p=0.001). The genotype frequencyof -2578*C/A polymorphism of VEGF gene was no difference between case andcontrol groups. However, individuals with C allele have a higher risk factor todevelop DFU than A allele (CC+CA vs AA;p=0.042; OR=2.5). The plasma VEGF-Alevels were lower in T2DM subjects with DFU than those without DFU. Inconclusion,individuals with C allele of -2578*C/A polymorphism of VEGF geneare more susceptible to have DFU than individuals with A allele in Javaneseethnic with T2DM.
The Effect of Telmisartan and Metformin on Insulin Resistance in Metabolic Syndrome Patients with Insulin Therapy Siswi Oktariani; Raden Bowo Pramono; Hemi Sinorita
Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (177.968 KB) | DOI: 10.22146/acta interna.5731

Abstract

ABSTRACTBackground: Recommendations for therapy insulin resistance are metformin and thiazolidindion. Side effects of thiazolidindion due to peripheral edema occurs to 2-5% and increased 5-15% when combined with insulin therapy. Telmisartan, an angiotensin receptor blocker, has anti-hypertensive effects and improve insulin resistance. Telmisartan effect on peroxisome proliferator activated receptor γ agonist and has the same structure of the group thiazolidindion, pioglitazone. The research objective was to determine the effects of telmisartan and metformin on insulin resistance in metabolic syndrome patients with insulin therapy.Methods: This study used a before-after design. The study was conducted in the internal medicine clinic of the endocrinology department of Dr. Sardjito Hospital Yogyakarta. Subjects were patients who met the diagnosis of metabolic syndrome based on the IDF 2005, hypertension and receive insulin therapy. Subjects given metformin and telmisartan therapy for 12 weeks. Subjects examined HOMA IR before and after treatment. The average decrease in HOMA IR was tested by paired t test or Wilcoxon test. P value <0.05 was considered signifi cant.Result: The total sample were 27 subjects. Data analysis was performed on 11 subjects. Fasting blood glucose before and after treatment was signifi cantly decreased (p<0.001) whereas the fasting insulin levels increased. HOMA IR was signifi cantly decreased after treatment {p = 0.004 (5.79 – 20.26), CI 95%}.Conclusion: this study found insulin resistance decreased signifi cantly in patients with the metabolic syndrome of insulin therapy who received metformin and telmisartan.Keywords : metabolic syndrome, insulin therapy, metformin, telmisartan, HOMA IR
The Difference Plasma Levels of Endotelin-1 in Type 2 Diabetes Mellitus Women with and without Hypertension Enita Rahmawati Kurniatmaja; Hemi Sinorita; Lutfan Budi Purnomo
Acta Interna The Journal of Internal Medicine Vol 5, No 1 (2015): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (208.249 KB) | DOI: 10.22146/acta interna.22356

Abstract

Background. Diabetes and hypertension are related to each other and have a strong pre-disposition on the incidence of atherosclerosis. The incidence of hypertension 2 times greater in patients with DM than non DM. Endothelial dysfunction underlies these events. Endothelial markers, endothelin-1 is known to affect blood pressure.Aim. The aim of this study is to determine the difference plasma levels of endothelin-1 in type 2 diabetes mellitus in women with and without hypertension.Methods. The cross sectional design was conducted on women with type 2 diabetes mellitus with and without hypertension at metabolic and endocrinology clinic, Dr. Sardjito General Hospital Yogyakarta from July 2010 until the sample met the criterias. Subjects were divided into two groups, type 2 DM woman with hypertension groups and without hypertension. ELISA sandwich’s method was used to measure plasma levels of endothelin-1. Characteristics of the study are presented in the form of mean Kurniaatmaja et al.Results. In this research, the plasma levels of endothelin-1 in in type 2 diabetes mellitus in women with hypertension (n=32) and without hypertension (n=32) respectively 19.17±7.53 ng/ml and 13.75±6.19 ng/dl, and this difference was stastistically signifi cant with p= 0.003 CI 95% -8.87 to -1.97.Conclusion. Plasma levels of endothelin-1 in type 2 diabetes woman with hypertension higher than without hypertension.