Diah Martina, Diah
Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta

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Profile and analysis of diabetes chronic complications in Outpatient Diabetes Clinic of Cipto Mangunkusumo Hospital, Jakarta Tarigan, Tri J.E.; Yunir, Em; Subekti, Imam; Pramono, Laurentius A.; Martina, Diah
Medical Journal of Indonesia Vol 24, No 3 (2015): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (344.752 KB) | DOI: 10.13181/mji.v24i3.1249


Background: Chronic complications of diabetes mellitus have a significant role in increasing morbidity, mortality, disability, and health cost. In the outpatient setting, the availability of data regarding to the chronic complications of type 2 diabetes is useful for evaluation of prevention, education, and patient’s treatment. This study aimed to describe the characteristic of type 2 diabetes chronic complications in outpatient diabetes clinic.Methods: A cross-sectional study was done using 155 patients in Outpatient Diabetes Clinic of Cipto Mangunkusumo Hospital (RSCM), Jakarta in 2010. Secondary data were used from medical record based on history taking, physical examination, diabetic foot assessment, laboratory, neurologic, cardiology, opthalmology, ankle brachial index, and electrography of the patients. Characteristic profiles of the subjects, prevalence of the chronic complications, and its association with diabetes risk factors, such as glycemic control using HbA1c, fasting blood glucose, duration of diabetes, and LDL cholesterol were analyzed using chi square test.Results: Among 155 subjects participated in the study, most of them were women (59%) and elderly (46%). The prevalence of diabetes chronic complications was 69% from all subjects. These chronic complications included microangiopathy, macroangiopathy and mixed complications, with prevalence of 56%, 7% and 27% respectively. Microangiopathy included nephropathy (2%), retinopathy (7%), neuropathy (38%) and mixed complications (53%). Macroangiopathy included coronary heart disease (46%), peripheral arterial disease (19%), stroke (18%), and mixed complication (17%). From the analysis, we found significant association between duration of diabetes and diabetic neuropathy (p = 0.003).Conclusion: Prevalence of diabetes chronic complications in Outpatient Diabetes Clinic of Cipto Mangunkusumo Hospital, mainly dominated by microvascular-related complications including nephropathy, retinopathy, neuropathy and mixed complications. There was statistical significance between diabetes duration and diabetic neuropathy.
Effect of Advance Care Planning on Heart Failure Patients: An Evidence Based Case Report Shatri, Hamzah; Nurfitria, Nandika; Sinulingga, Dika; Irvianita, Vinandia; Faisal, Edward; Putranto, Rudi; Martina, Diah
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
Publisher : UI Scholars Hub

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Despite the advances in medical therapy, heart failure remains a disease that requires attention due to the course of the illness; it can lead to unpredictable, progressive, and fatal conditions. Existing therapy aims to improve the condition and prevent disease progression, with a balanced secondary therapy for various conditions that can trigger acute decompensated heart failure. Advances in technology and therapy may increase the prevalence of patients with heart failure, including prolonging the refractory phase of the disease. There are recommendations for advance care planning to support patient therapy and improve the quality of life of patients with heart failure. This evidence-based case report aims to investigate the benefits of advance care planning in heart failure patients. A heart failure patient is referred to the palliative care team for advance care planning. Literature searches were conducted on ProQuest, PubMed, Scopus, and Cochrane according to the clinical questions. The studies were selected based on the inclusion and exclusion criteria, then a critical review was conducted. One study showed significant results regarding the effectiveness of advance care planning on the quality of life of heart failure patients. Another study showed a significant improvement in depression among patients engaged in advance care planning. However, it showed no difference in the quality of life compared to usual care because the sample size was relatively small, and the quality of evidence was low. Therefore, it can be concluded that advance care planning can improve heart failure patients’ psychological symptoms and quality of life.