Dinnarwika, Syarah Nandya and dr. Wino Vrieda Vierlia, Sp.M(K) and Dr. dr. Debby Shintiya Dewi, Sp.M(K) (2024) Hubungan Antara Kadar Gula Darah Dengan Derajat Keparahan Dan Aktivitas Klinis Thyroid Eye Disease. Magister thesis, Universitas Brawijaya.
Abstract
Tujuan: untuk menilai hubungan antara kadar gula darah dengan derajat keparahan dan aktivitas klinis pada pasien TED. Metode: penelitian ini menggunakan desain observasional analitik dengan pendekatan cross-sectional pada bulan Januari hingga Desember 2023 di Rumah Sakit Dr. Saiful Anwar Malang. Responden kemudian dilakukan anamnesis, pemeriksaan mata lengkap, dan pemeriksaan laboratorium kadar gula darah meliputi HbA1c (Hemoglobin Terglikasi), GDP (Gula Darah Puasa), GD2PP (Gula Darah 2 jam Post Prandial). Kemudian hasil pemeriksaan responden dikelompokkan berdasarkan derajat keparahan dan aktivitas klinis. Hasil: pada penelitian ini terdapat sebanyak 40 mata dari 20 responden dengan rata-rata usia 39,50 ± 15,08 tahun, dimana 75% responden adalah wanita. Dari 20 responden didapatkan 9 mata TED ringan, 26 mata TED sedang-berat dan 5 mata TED sangat berat. Diperoleh nilai median HbA1c berdasarkan derajat keparahan adalah 6.20% (ringan), 5.85% (sedang-berat), dan 5.50% (sangat berat). Data median kadar gula GDP sebesar 100 mg/dL (ringan), 99.50 mg/dL (sedang-berat), dan 98.0 mg/dL (sangat berat). Sedangkan GD2PP berdasarkan derajat keparahan diperoleh nilai median 133 mg/dL (ringan), 135 mg/dL (sedang-berat), dan 96 mg/dL (sangat berat). Diperoleh data median HbA1c pada kelompok aktif sebesar 5.7% dan kelompok inaktif sebesar 5.9%. Data median GDP adalah 115 mg/dL (aktif) dan 96 mg/dL (inaktif). Data median GD2PP 104 mg/dL (aktif) dan 133 mg/dL (inaktif). Analisis perbandingan dan hubungan HbA1c dengan derajat keparahan TED didapatkan nilai p sebesar 0.226 dan 0.226. Analisis perbandingan dan hubungan antara GDP dengan derajat keparahan TED diperoleh nilai p sebesar 0.742 dan 0.597. Sedangkan analisis perbandingan dan hubungan antara GD2PP dengan derajat keparahan TED didapatkan nilai p sebesar 0.006 dan 0.032. Hasil analisis perbandingan dan hubungan antara HbA1c dengan aktivitas klinis TED didapatkan nilai p sebesar 0.839 dan 0.823. Hasil analisis perbandingan dan hubungan antara GDP dengan aktivitas klinis TED diperoleh hasil p sebesar 0.041 dan 0.039. Sedangkan hasil uji perbandingan dan hubungan antara GD2PP dengan aktivitas klinis TED didapatkan nilai p sebesar 0.271 dan 0.260. Kesimpulan: pada penelitian ini, diantara HbA1c, GDP, dan GD2PP sebagai parameter kadar gula darah, hanya GD2PP yang memiliki hubungan yang signifikan terhadap derajat keparahan TED, dimana GD2PP didapatkan lebih rendah pada TED sangat berat dibandingkan dengan derajat lainnya. Sedangkan diantara HbA1c, GDP, dan GD2PP sebagai parameter kadar gula darah, hanya GDP yang memiliki hubungan yang signifikan terhadap aktivitas klinis TED, dimana kadar GDP pada TED aktif lebih tinggi dibandingkan dengan TED inaktif.
English Abstract
Objective: to assess the affect of blood glucose levels on the degree of severity and clinical activity in TED patients. Methods: this study used an analytical observational design with a cross-sectional approach for one year period in a tertiary hospital. Thorough history taking, complete eye examination, and laboratory examination of blood glucose levels including HbA1c (Glycated Hemoglobin), FBG (Fasting Blood Glucose), and PPG (Post Prandial Glucose) were applied to all respondents. Inclusion criteria were patients diagnosed with TED at eye clinic, who also did not have other causes of optic neuropathy, has never received previous steroid therapy related to TED, and willing to be a subject in this research. Respondents who have blood disorders that cannot be done with blood tests were exclude from this study. The respondents were then divided into groups based on the degree of severity and clinical activity. Results: there were 40 eyes from 20 respondents included in this study with an average age of 39.50 ± 15.08 years, of which 75% were woman. Of the 20 respondents, 9 had mild TED, 26 moderate-severe TED and 5 very severe TED. The median HbA1c levels obtained based on severity were 6.20% (mild), 5.85% (moderate-severe), and 5.50% (very severe). The median of FPG were 100 mg/dL (mild), 99.50% mg/dL (moderate-severe), and 98.0 mg/dL (very severe). Meanwhile, PPG obtained a median value of 133 mg/dL (mild), 135 mg/dL (moderate-severe), and 96 mg/dL (very severe). The median of HbA1c obtained in the active group was 5.7% and 5.9% in inactive group. The median of FPG levels was 115 mg/dL (active) and 96 mg/dL (inactive). Meanwhile, PPG levels was 104 mg/dL (active) and 133 mg/dL (inactive). The comparation and correlation between HbA1c and the severity of TED was found to be p = 0.226 and 0.226. The comparation and correlation between FPG levels and the severity of TED obtained a value of p = 0.742 and 0.597. Meanwhile, the correlation between PPG levels and the severity of TED was found to have a value of 0.006 and 0.032. The results of the comparation and correlation between HbA1c and TED clinical activity obtained a p value 0.839 and 0.823. The results of the the comparation and correlation between FPG and TED clinical activity showed p = 0.041 and 0.039. Meanwhile, the results of The comparation and correlation between GD2PP and TED clinical activity obtained a p value 0.271 and 0.260. Conclusion: PPG had a significant relationship with the severity of TED and found to be lower in very severe TED compared to other degrees. While FPG levels were signoficantly higher in active stage than inactive stage in terms of clinical activity of TED
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | 042406 |
| Uncontrolled Keywords: | kadar gula darah, thyroid eye disease, derajat keparahan, aktivitas klinis-blood glucose levels, thyroid eye disease, clinical severity, clinical activity |
| Divisions: | Profesi Kedokteran > Spesialis Ilmu Kesehatan Mata, Fakultas Kedokteran |
| Depositing User: | Unnamed user with username nova |
| Date Deposited: | 01 Oct 2024 01:33 |
| Last Modified: | 01 Oct 2024 01:33 |
| URI: | http://repository.ub.ac.id/id/eprint/225404 |
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