Keterlambatan Diagnosis Diabetes Mellitus pada Kehamilan

Authors

  • Herwindo Pudjo Brahmantyo Program Pendidikan Dokter Spesialis - ! Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Brawijaya Rumah Sakit dr. Saiful Anwar
  • Ade Nurshanty Program Pendidikan Dokter Spesialis - ! Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Brawijaya Rumah Sakit dr. Saiful Anwar
  • Laksmi Sasiarini Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Brawijaya Rumah Sakit dr. Saiful Anwar

DOI:

https://doi.org/10.21776/ub.jkb.2017.029.03.18

Keywords:

Diabetes mellitus, kehamilan, komplikasi

Abstract

Prevalensi wanita dengan diagnosis Diabetes Mellitus (DM) meningkat sepanjang tahunnya termasuk dalam kehamilan. Kami laporkan kasus seorang wanita 36 tahun dengan persalinan anak pertama yang dikonsultasikan dengan peningkatan gula darah sesudah persalinan. Dari hasil anamnesa dan pemeriksaan fisik tidak didapatkan riwayat DM pada pasien dan keluarga yang dapat menjadi penyebab keterlambatan diagnosis DM pada kehamilan. Anamnesis, observasi dan hasil pemeriksaan laboratorium mengindikasikan potensi DM yang dimulai sebelum kehamilan namun tidak dikonfirmasi melalui skrining pemeriksaan gula darah pada kehamilan. Bayi yang dilahirkan mempunyai berat badan normal namun sempat mengalami hipoglikemia. Pasien diberikan terapi injeksi insulin basal dimulai pada dosis 6 iu dan dinaikkan bertahap menjadi 8 iu dan 10 iu, sesuai dengan hasil evaluasi hingga tujuan terapi tercapai. Kasus ini menunjukkan pentingnya penggalian riwayat dengan teliti dan skrining DM dalam kehamilan pada mereka yang berisiko untuk mencegah komplikasi pada janin maupun ibu.
Kata Kunci: Diabetes mellitus, kehamilan, komplikasi

 

Downloads

Download data is not yet available.

Author Biographies

Herwindo Pudjo Brahmantyo, Program Pendidikan Dokter Spesialis - ! Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Brawijaya Rumah Sakit dr. Saiful Anwar

Residen Ilmu Penyakit Dalam

Ade Nurshanty, Program Pendidikan Dokter Spesialis - ! Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Brawijaya Rumah Sakit dr. Saiful Anwar

Residen Ilmu Penyakit Dalam

Laksmi Sasiarini, Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Brawijaya Rumah Sakit dr. Saiful Anwar

Staf Divisi Endokrin, Metabolik dan Diabetes

References

Gonzalez GNL, Gonzales DE, Castro A, Padron E, and Plasencia W. Effect of Pregestational Diabetes Mellitus On First Trimester Placental Characteristics: Three-Dimensional Placental Volume and Power Doppler Indices. Placenta. 2014; 35(3): 147-151.

Ko JY, Dietz PM, Conrey EJ, et al. Gestational Diabetes Mellitus and Postpartum Care Practices of Nurse-Midwives. Journal of Midwifery &Women's Health. 2013; 58(1): 33-40.

Noctor E and Dunne FP. Type 2 Diabetes after Gestasional Diabetes: The Influence of Changing Diagnostic Criteria. World Journal of Diabetes. 2015; 6(2): 234-244.

Qadir SY, Yasmin T, and Fatima I. Maternal and Foetal Outcome in Gestational Diabetes. Journal of Ayub Medical College Abbottabad. 2012; 24(3-4): 17-20.

R McCane D and McNamara M. Guidelines for the Management of Pre-gestational and Gestational Diabetes Mellitus from Pre-conception to the Postnatal period. Dublin: Health Service Executive; 2010; pp. 1-88.

Nankervis A and Conn J. Gestational Diabetes Mellitus Negotiating the Confusion. Australian Family Physician 2013; 42(8): 528-531.

Bental Y, Reichman B, Shiff Y, et al. Impact of Maternal Diabetes Mellitus on Mortality and Morbidity of Preterm Infants (24–33 Weeks' Gestation). Pediatrics. 2011;128(4): e848-e855.

Wahabi HA, Esmaeil SA, Fayed A, Al-Shaikh G, and Alzeidan RA. Pre-Existing Diabetes Mellitus and Adverse Pregnancy Outcomes. BioMed Central Research Notes. 2012; 5: 496.

Karagiannis T, Bekiari E, Manolopoulos K, Paletas K, and Tsapas A. Gestational Diabetes Mellitus: Why Screen and How To Diagnose. Hippokratia. 2010; 14(3): 151-154.

Bennett SN, Tita A, Owen J, Biggio JR, and Harper LM. Assessing White's Classification of Pregestational Diabetes in a Contemporary Diabetic Population. Obstetrics and Gynecology. 2015; 125(5): 1217–1223.

Gilmartin ABH, Ural SH, and Repke JT. Gestational Diabetes Mellitus. Reviews in Obstetrics & Gynecology. 2008;1(3): 129-134.

Grant RW, Donner TW, Fradkin JE, et al. Standards of Medical Care in Diabetes—2015. Diabetes care. 2015; 38(supplement 1): S1-S94.

Hone J and Jovanovic L. Approach to the Patient with Diabetes During Pregnancy. The Journal of Clinical Endocrinology and Metabolism. 2010; 95(8): 3578-3585.

Thacker SM and Petkewicz KA. Gestational Diabetes Mellitus. US Pharmacist. 2009; 34(9): 43-48.

Kitzmiller JL, Block JM, Brown FM, et al. Managing Preexisting Diabetes for Pregnancy: Summary of Evidence and Consensus Recommendations for Care. Diabetes Care. 2008; 31(5): 1060-1079.

Saifuddin AB, Adriaanz G, Wiknjosastro GH, dan Waspodo D. Buku Acuan Nasional Pelayanan Kesehatan Maternal dan Neonatal. Jakarta: Yayasan Bina Pustaka Sarwono Prawihardjo; 2006.

Kitzmiller JL, Dang-Kilduff L, and Taslimi MM. Gestational Diabetes after Delivery Short-Term Management and Long-Term Risks. Diabetes Care. 2007; 30(Suplement 2): S225-S235.

Srichumchit S, Luewan S, and Tongsong T. Outcomes of Pregnancy with Gestational Diabetes Mellitus. International Journal of Gynaecology and Obstetrics. 2015; 131(3): 251–254.

Downloads

Published

2017-02-06

Issue

Vol 29, No. 3 (2017)

Section

Case Report

License

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).