Analisis Efektivitas Insulin Analog dan Human yang Digunakan pada Penderita Diabetes Melitus Tipe-2 dengan Biaya BPJS di RS. Islam Sukapura 2018
DOI:
https://doi.org/10.24853/mujg.2.1.17-26Keywords:
diabetes melitus tipe-2, effectiveness, farmakoekonomi, insulin analog, insulin humanAbstract
Latar Belakang: Insulin merupakan obat diabetes melitus tipe-2 terutama digunakan pada pasien yang sudah tidak responsif dengan obat oral. Dikenal 2 kelompok insulin yaitu insulin analog dan insulin human. Strategi pengobatan optimal untuk pasien diberikan antidiabetik oral. Apabila kadar HbA1c > 7%, dapat diberikan insulin atau antidiabetik oral monoterapi Tujuan: Tujuan penelitian ini adalah membandingkan efektifitas pengobatan menggunakan obat insulin analog dan insulin human di RS. Islam Sukapura dalam periode Januari– Desember 2018. Metode: Studi retrospektif ini dilakukan berdasarkan rekam medis pasien diabetes melitus tipe-2 yang berobat di poliklinik penyakit dalam RS.Islam Sukapura dalam periode Januari–Desember 2018. Uji statistic yang digunakan yaitu uji beda mann-whitney dan uji chi-square. Hasil: Dari 200 pasien terdapat 82 orang yang mendapatkan insulin human dan rata-rata selisih HbA1c awal dan akhir sebesar 1,40 %. Pada 118 pasien yang mendapatkan insulin analog, rata-rata selisih HbA1c awal dan akhir sebesar 1,34 %. Secara statistik tidak terdapat perbedaan bermakna antara rerata selisih HbA1c awal dan akhir pasien yang mendapatkan insulin human dan insulin analog (P=0,785). Efek samping insulin yang ditemukan seperti hipoglikemia sebesar 3,5% yang dapat terjadi pada pemberian Insulin dalam jangka waktu lama dan pada dosis yang besar. Simpulan: Tidak ada perbedaan yang bermakna secara statistik maupun klinik efektifitas insulin human dibandingkan insulin analog.References
World Health Organization. Diabetes di Indonesia. Diabetes Fakta dan Angka. 2016.
Pusat Data dan Informasi Kementerian Kesehatan Republik Indonesia. Situasi dan Analisis Diabetes. 2014.
Badan Pusat Statistik, Badan Koordinasi Keluarga Berencana Nasional, Departemen Kesehatan, Macro Internasional. Survei Demografi dan Kesehatan Indonesia 2007. Jakarta; 2008.
Baynest HW. Classification, Pathophysiology, Diagnosis and Management of Diabetes Mellitus. J Diabetes Metab. 2015;06(05):1–9.
DeFronzo RA. From the Triumvirate to the Ominous Octet: A New Paradigm for the Treatment of Type 2 Diabetes Mellitus. Diabetes. 2009 Apr 1;58(4):773–95.
Cersosimo E, Solis-Herrera C, Trautmann M, Malloy J, Triplitt C. Assessment of Pancreatic & Cell Function: Review of Methods and Clinical Applications. Curr Diabetes Rev. 2014 Mar 31;10(1):2–42.
Aslan I, Kucuksayan E, Aslan M. Effect of insulin analog initiation therapy on LDL/HDL subfraction profile and HDL associated enzymes in type 2 diabetic patients. Lipids Health Dis. 2013 Dec 24;12(1):54.
Ionut V, Zheng D, Stefanovski D, Bergman RN. Exenatide can reduce glucose independent of islet hormones or gastric emptying. Am J Physiol Metab. 2008 Aug;295(2):E269–77.
Mannucci E, Monami M, Marchionni N. Short-acting insulin analogues vs. regular human insulin in type 2 diabetes: a meta-analysis. Diabetes, Obes Metab. 2009 Jan;11(1):53–9.
Handelsman Y, Bloomgarden ZT, Grunberger G, Umpierrez G, Zimmerman RS, Bailey TS, et al. American Association of Clinical Endocrinologists and American College of Endocrinology--Clinical Practice Guidelines for Developing A Diabetes Mellitus Comprehensive Care Plan--2015--Executive Summary. Endocr Pract. 2015 Apr;21(4):413–37.
American Diabetes Association. Executive Summary: Standards of Medical Care in Diabetes--2014. Diabetes Care. 2014 Jan 1;37:S5–13.
Machado-Alba JE, Medina-Morales DA. Comparison of the impact of human vs analogue insulins on glycosylated haemoglobin in a population with diabetes mellitus. Int J Clin Pract. 2016 Dec;70(12):996–1002.
Auryan S, Itamar R. Gender-specific care of diabetes mellitus: particular considerations in the management of diabetic women. Diabetes, Obes Metab. 2008 May 20;10(12):1135–56.
Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar 2013. Badan Penelitian dan Pengembangan Kesehatan. Jakarta: Kementerian Kesehatan Republik Indonesia; 2013.
Kasier Permante Washington. Type 2 Diabetes Screening and Treatment Guideline Major Changes as of June 2015. 2015 p. 1–17.
Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, et al. Management of Hyperglycemia in Type 2 Diabetes, 2015: A Patient-Centered Approach: Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2015 Jan 23;38(1):140–9.
Medical Development Division Ministry of Health Malaysia. Health Technology Assessment: Insulin Analogues. Putrajaya, Malaysia; 2012.
Yoo HJ, Park KY, Park KS, Ahn KJ, Min KW, Park JH, et al. Safety and Efficacy of Modern Insulin Analogues. Diabetes Metab J. 2013;37(3):181.
Borgquist S, Rosendahl AH, Czene K, Bhoo-Pathy N, Dorkhan M, Hall P, et al. Long-term exposure to insulin and volumetric mammographic density: observational and genetic associations in the Karma study. Breast Cancer Res. 2018 Dec 9;20(1):93.
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