Profil Neuropati Perifer Berdasarkan Skor Pain DETECT pada Penderita Diabetes Melitus Tipe 2 yang Menggunakan Metformin di Puskesmas Unaaha
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Abstract
Diabetes melitus tipe 2 menunjukkan peningkatan prevalensi di Indonesia dari 6,9% (2013) menjadi 8,5% (2018). Di Sulawesi Tenggara khususnya, prevalensi diabetes meningkat dari 1,1% menjadi 1,3% dalam periode yang sama. Kabupaten Konawe sendiri mencatat prevalensi diabetes sebesar 1,77%, lebih tinggi dibandingkan wilayah lainnya seperti Kota Bau-Bau dan Kabupaten Konawe Kepulauan. Neuropati perifer merupakan komplikasi utama diabetes (45,6%), dan penggunaan metformin sebagai terapi lini pertama telah dikaitkan dengan defisiensi vitamin B12 yang dapat meningkatkan risiko neuropati perifer hingga 84%. Penelitian menunjukkan bahwa penggunaan metformin jangka panjang dapat menyebabkan defisiensi vitamin B12 melalui gangguan penyerapan di usus, yang pada gilirannya menyebabkan peningkatan kadar homosistein dan asam metilmalonat yang dapat memicu kerusakan saraf perifer. Pain DETECT dipilih sebagai instrumen skrining karena memiliki sensitivitas 85% dan spesifisitas 80% dalam mendeteksi komponen nyeri neuropatik. Tingginya prevalensi diabetes melitus tipe 2 di Kabupaten Konawe, risiko komplikasi neuropati perifer pada penggunaan metformin jangka panjang, serta belum adanya data komprehensif mengenai profil neuropati perifer berdasarkan skor Pain DETECT di Puskesmas Unaaha menjadi dasar pentingnya penelitian ini. Hasil penelitian diharapkan dapat memberikan gambaran nyata tentang kejadian neuropati perifer dan menjadi dasar untuk strategi pencegahan serta penanganan yang lebih baik.
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References
Adi, S. (2019) ‘Pengelolaan Dan Pencegahan Diabetes Melitus Tipe 2 Dewasa di Indonesia’, PB Perkeni, p. 133.
Artha IMJR, Bhargah A, Dharmawan NK, Pande UW, Triyana KA, Mahariski PA, et al. (2019) High level of individual lipid profile and lipid ratio as a predictive marker of poor glycemic control in type-2 diabetes mellitus. Vasc Health Risk Manag.
Damughatla, A. R. et al. (2022) ‘A Novel Case of Metformin-Induced Pancreatitis in an Individual With Normal Dosing and No Underlying Chronic Kidney Disease’, Cureus. doi: 10.7759/cureus.25116.
Dias, M. J. L. E., Pereira, B. L. B. and Orrico, S. R. P. (2023) ‘Vitamin B12 Deficiency and Peripheral Neuropathy in patients with Type 2 Diabetes Mellitus Treated with Metformin. An integrative review’, Brazilian Journal of Health Review, 6(3), pp. 9534–9548. doi: 10.34119/bjhrv6n3-091.
Foretz, M., Guigas, B. and Viollet, B. (2023) ‘Metformin: Update on Mechanisms of Action and Repurposing Potential’, Nature Reviews Endocrinology. doi: 10.1038/s41574-023-00833-4.
Freynhagen, R. et al. (2006) ‘painDETECT: A new screening questionnaire to identify neuropathic components in patients with back pain’, Current Medical Research and Opinion, 22(10), pp. 1911–1920. doi: 10.1185/030079906X132488.
Gupta, K., Jain, A. and Rohatgi, A. (2018) ‘An observational study of vitamin b12 levels and peripheral neuropathy profile in patients of diabetes mellitus on metformin therapy’, Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 12(1), pp. 51–58. doi: https://doi.org/10.1016/j.dsx.2017.08.014.
Huang, Y. et al. (2019) ‘Comparison of Gastrointestinal Adverse Events With Different Doses of Metformin in the Treatment of Elderly People With Type 2 Diabetes’, Journal of Clinical Pharmacy and Therapeutics. doi: 10.1111/jcpt.13087.
K. J. Kim, Byung-wan Lee, Hyun-Min Kim, Joo Youn Shin, E. Kang, B. Cha, Eun Jig Lee, S. L. and H. C. L. (2011) ‘Associations between cardio-ankle vascular index and microvascular complications in type 2 diabetes mellitus patients’, Journal of atherosclerosis and thrombosis, 18(4), pp. 328–36. doi: https://doi.org/10.5551/JAT.5983.
LaMoia, T. E. and Shulman, G. I. (2020) ‘Cellular and Molecular Mechanisms of Metformin Action’, Endocrine Reviews. doi: 10.1210/endrev/bnaa023.
Ong, C. (2022) ‘Characteristic of Chronic Complications in Type 2 Diabetic Patient Based on Asian Perspective’, Current Internal Medicine Research and Practice Surabaya Journal, 3(1), p. 13. doi: 10.20473/cimrj.v3i1.31412.
PAN, Q. I., LUO, J. and GUO, L. (2022) ‘467-P: The Relationship between Diabetic Peripheral Neuropathy and Metformin Treatment in Type 2 Diabetes Mellitus’, Diabetes, 71(Supplement_1), pp. 467-P. doi: 10.2337/db22-467-P.
Raman, R. et al. (2012) ‘Prevalence and risk factors for diabetic microvascular complications in newly diagnosed type II diabetes mellitus. Sankara Nethralaya Diabetic Retinopathy Epidemiology And Molecular Genetic Study (SN-DREAMS, report 27)’, Journal of Diabetes and its Complications, 26(2), pp. 123–128. doi: https://doi.org/10.1016/j.jdiacomp.2012.02.001.
Riskesdas (2013) ‘Riset Kesehatan Dasar (RISKESDAS) 2013’, Laporan Nasional 2013, p. 1.
Riskesdas (2018) Laporan Riskesdas 2018 Provinsi Sulawesi Tenggara, Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan (LPB).
Roy, R. P. et al. (2016) ‘Original Article Study of Vitamin B 12 deficiency and peripheral neuropathy in metformin ‑ treated early Type 2 diabetes mellitus’, pp. 631–637. doi: 10.4103/2230-8210.190542.
Soewondo, P., Ferrario, A. and Tahapary, D. L. (2013) ‘Challenges in diabetes management in Indonesia: A literature review’, Globalization and Health, 9(1), pp. 1–17. doi: 10.1186/1744-8603-9-63.
Margareta K, Aninditha T, Hakim M, Herqutanto, Kuniawan M. Adaptasi transkultural kuesioner paindetect ke dalam bahasa Indonesia. Neurona. 2017;34(3).
Triastuti, N. et al. (2020) ‘Faktor yang Mempengaruhi Tingkat Kepatuhan Konsumsi Obat Antidiabetes Oral pada Pasien Diabetes Melitus Tipe 2 di RSUD Kabupaten Jombang’, Medica Arteriana (Med-Art), 2(1), p. 27. doi: 10.26714/medart.2.1.2020.27-37.
Wile, D. J. and Toth, C. (2010) ‘Association of metformin, elevated homocysteine, and methylmalonic acid levels and clinically worsened diabetic peripheral neuropathy’, Diabetes Care, 33(1), pp. 156–161. doi: 10.2337/dc09-0606.
Yang, R. et al. (2023) ‘Metformin treatment and risk of diabetic peripheral neuropathy in patients with type 2 diabetes mellitus in Beijing , China’, (February), pp. 1–8. doi: 10.3389/fendo.2023.1082720.