Hubungan antara Status Kontrol Glikemik, Vitamin D dan Gizi pada Anak Diabetes Melitus Tipe 1

Authors

  • Ratna Indriyani Ilmu Kesehatan Anak Rumah Sakit Umum Daerah Saiful Anwar Malang Fakultas Kedokteran Universitas Brawijaya
  • Harjoedi Adji Tjahjono

DOI:

https://doi.org/10.21776/ub.jkb.2018.030.02.7

Keywords:

Diabetes melitus tipe 1, HbA1c, status gizi, status kontrol glikemik, status vitamin D

Abstract

Di beberapa negara barat kasus DM tipe-1 adalah 5-10% dari kasus  diabetes, dan lebih dari 90% penderita diabetes pada anak dan remaja adalah DM tipe-1. Vitamin D berperan penting dalam membangun dan memelihara mineralisasi tulang. Defisiensi vitamin D dapat menyebabkan penekanan bone turnover sehingga menyebabkan gangguan kecepatan tinggi badan. Kontrol glikemik yang buruk berupa HbA1c yang tinggi dapat menyebabkan berat dan tinggi badan tidak naik secara adekuat. Penelitian ini bertujuan untuk membuktikan hubungan antara status kontrol glikemik(HbA1c), status vitamin D (25(OH)D), dan status gizi pada anak DM tipe-1. Desain penelitian berupa studi cross-sectional dilakukan pada 28 subjek penelitian yaitu anak DM tipe 1 usia 1-18 tahun yang menjalani rawat jalan di Poli Endokrinologi Rumah Sakit Umum dr. Saiful Anwar Malang. Kriteria eksklusi yaitu menderita penyakit autoimun lain, infeksi berat, gangguan hati, gangguan fungsi ginjal dan  anemia. Variabel yang diukur status gizi, kadar HbA1c dan 25(OH)D. Untuk mengetahui perbedaan rerata kadar 25(OH)D dan HbA1c berdasarkan status gizi digunakan uji beda Kruskal wallis, dan uji korelasi Spearman. Dari 28 subjek didapatkan 68% anak dengan status gizi baik, 64% anak dengan kontrol metabolik buruk dan 61% anak dengan defisiensi/insufisensi 25(OH)D. Tidak terdapat hubungan yang bermakna antara status gizi, kontrol glikemik,  dan vitamin D. 

Downloads

Download data is not yet available.

Author Biography

Ratna Indriyani, Ilmu Kesehatan Anak Rumah Sakit Umum Daerah Saiful Anwar Malang Fakultas Kedokteran Universitas Brawijaya

Ilmu Kesehatan Anak
Rumah Sakit Umum Daerah Saiful Anwar Malang
Fakultas Kedokteran Universitas Brawijaya

References

Zóka A, Műzes G, Somogyi A, et al. Altered Immune Regulation in Type 1 Diabetes. Clinical and Developmental Immunology. 2013; 10(7): 1-17.

Sperling Mark A. Pediatric Endocrinology. 4th edition. New York: Elsevier; pp.141-144.

Craig ME, Jefferies C, Dabelea D, Balde N, Seth A, and Donaghue KC. Definition, Epidemiology, and Classification of Diabetes in Children and Adolescents. Pediatric Diabetes. 2014; 15(20): 4-17.

Tridjaja B, Niken PY, M. Faizi, et al. Konsensus Nasional Pengelolaan Diabetes Melitus Tipe 1. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2015; hal.1-10.

Laboratorium Rekam Medik. Data Jumlah Pasien Diabetes Melitus di Rumah Sakit Saiful Anwar Malang Periode 2011-2016. Bagian Rekam Medik RSSA. Malang; Rumah Sakit Umum dr. Saiful Anwar; 2016.

Mathieu C. Vitamin D and the Immune System: Getting It Right. International Bone & Mineral Society BoneKEy. 2011; 8(4): 178-186.

Baeke F, Takiishi T, Korf H, Gysemans C, and Mathieu C. Vitamin D: Modulator of the Immune System. Current Opinion in Pharmacology. 2010; 10(4): 482-496.

Takiishi T, Gysemans C, Bouillon R, and Mathieu C. Vitamin D and Diabetes. Endocrinology and Metabolism Clinics of North America. 2010; 39(2): 419-446.

Mitri J and Pittas AG. Vitamin D and Diabetes. Endocrinology and Metabolism Clinics of North America. 2014; 43(1): 205-232.

Janner M, Ballinari P, Mullis PE, and Flück CE. High Prevalence of Vitamin D Deficiency in Children and Adolescent with Type 1 Diabetes. Swiss Medical Weekly. 2010; 140: 1-6.

Greer S, Portelli L, Hung BS, et al. Serum Vitamin D Levels Are Lower in Australian Children and Adolescents with Type 1 Diabetes Than in Children without Diabetes. Pediatric Diabetes. 2012; 14(1): 31-41.

Ginanjar E, Sumariyono, Setiati S, and Setiyohadi B. Vitamin D and Autoimmune Disease. Acta Medica Indonesiana. 2007; 39(3): 133-41.

Virmani A. Growth Disorders in Type 1 Diabetes: An Indian Experience. Indian Journal of Endocrinology and Metabolism. 2015; 19(1): S64-S67.

Parthasarathy L, Khadilkar V, Chiplonkar S, and Khadilkar V. Longitudinal Growth in Children and Adolescents with Type 1 Diabetes. Indian Pediatrics. 2016; 53(11): 990-992.

Svoren BM, Volkening LK, Wood JR, and Laffel LM. Significant Vitamin D Deficiency in Youth with Type 1 Diabetes Mellitus. The Journal of Pediatrics. 2009; 154(1): 132-134.

Sastroasmoro S. Pemilihan Subjek Penelitian. Di dalam: Sastroasmoro S dan S Ismal (Eds). Dasar-dasar Metodologi Penelitian Klinis Edisi 4. Jakarta: Sagung Seto; 2011: hal. 359.

Kalyva E, Malakonaki E, Eiser C, and Mamoulakis D. Health-Related Quality of Life (HRQoL) of Children with Type 1 Diabetes Mellitus (T1DM): Self and Parental Perceptions. Pediatric Diabetes. 2011; 12(1): 34-40.

Pereira DA, Costa NMSC, Sousa ALL, Jardim PCBV, and Zanini CRO. The Effect of Educational Intervention on the Disease Knowledge of Diabetes Mellitus Patients. The Revista Latino-Americana de Enfermagem. 2012; 20(3): 478-485.

da Costa VM, Padilha PC, Lima GCF, et al. Overweight among Children and Adolescent with Type I Diabetes Mellitus: Prevalence and Associated Factors. Diabetology & Metabolic Syndrome. 2016; 8(39): 1-18.

Cahyono HA. Gambaran Klinis dan Laboratoris Diabetes Melitus Tipe-1 pada Anak. Jurnal Kedokteran Brawijaya. 2013; 26(4): 195-198.

Hassanein MA and Sultan I. Evaluation of Nutrition and Health Status among Children with Diabetes. Life Science Journal. 2014; 11(2): 327-334.

Batubara J, Susanto R, dan Cahyono HA. Pertumbuhan dan Gangguan Pertumbuhan. Di dalam: Batubara JRL, Tridjaja B, dan Pulungan AB (Eds). Buku Ajar Endokrinologi Anak Edisi 1. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2010; hal. 19-42.

Hassan MM, Alashmawy AA, Sharaf FA, et al. Vitamin D Status in Egyptian Children and Adolescents with Type 1 Diabetes Mellitus. Journal of Diabetes & Metabolism. 2016; 7(1): 1-4.

Borkar VV, Devidayal, Verma S, and Bhalla, K. Low Levels of Vitamin D in North Indian Children with Newly Diagnosed Type 1 Diabetes. Pediatric Diabetes. 2010; 11(5): 345-350.

Wulandari D, Cahyono HA, Widjajanto E, and Puryatni A. Low Levels of Vitamin D correlate with Hemoglobin A1c and Interleukin-10 Levels in Pediatric Type 1 Diabetes Mellitus Patients. The Journal of Tropical Life Science. 2014; 4(3): 182-186.

Holick MF. Diabetes and the Vitamin D Connection. Current Diabetes Reports. 2008; 8(5): 393-398.

Handono K, Puspitasari L, Rudijanto A, Wahono S, and Kalim H. Vitamin D Serum Level and Disease Activity in Patients with Systemic Lupus Erythematosus. International Journal of Pharmaceutical Science Invention. 2013; 2(2): 35-40.

Al-Agha AE and Ahmad IA. Association among Vitamin D Deficiency, Type 1 Diabetes Mellitus and Glycemic Control. Journal of Diabetes Metabolism. 2015; 6(9): 1-5.

Rajashree R, Ravishankar MV, Kholkute SD, and Goudar SS. Type 1 Diabetes Mellitus: An Update. International Journal of Diabetes & Metabolism. 2012; 20(3): 37-42.

Balasubramanian S, Dhanalakshmi K, and Amperayani S. Vitamin D Deficiency in Childhood a Review of Current Guidelines on Diagnosis and Management. Endocrine Pediatric Journal. 2013; 50(7): 669-674.

Dong JY, Zhang WG, Chen JJ, Zhang ZL, Han SF, and Qin LQ. Vitamin D Intake and Risk of Type 1 Diabetes: A Meta-Analysis of Observational Studies. Nutrients. 2013; 5(9): 3551-3562.

Zhukouskaya VV, Eller Vainicher C, Shepelkevich AP, Dydyshko Y, Cairoli E, and Chiodini I. Bone Health in Type 1 Diabetes: Focus on Evaluation and Treatment in Clinical Practice. Journal of Endocrinological Investigation. 2015; 38(9): 941-950.

Sherwani SI, Khan HA, Ekhzaimy A, Masood A, and Sakharkar MK. Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomarker Insight. 2016; 11: 95-104.

International Society for Pediatrics and Adolescent Diabetes. Diabetes in Childhood and Adolescence. ISPAD Clinical Practice Consensus Guidelines. (Online) 2011. https://www.ispad.org/page/IDFISPAD2011?

Demir K, Altıncık A, Abacı A, Büyükgebiz A, and Böber E. Growth of Children with Type 1 Diabetes Mellitus. Journal of Clinical Research Pediatric Endocrinology. 2010; 2(2): 72-77.

Assar S, Riahi A, Bashirnezhad S, Yazdanpanah L, and Latifi SM. The Relationship between Metabolic Control and Growth in Children with Type I Diabetes Mellitus in Southwest of Iran. Scientifica. 2015; 2015: 1-5.

Cruz JN Z, Martínez GED, Keever MÃV, et al. Pediatric Patients with Type 1- Diabetes: Growth and Growth Failure Associated Factor. Boletin Medico del Hospital Infantil de Mexico. 2016; 73(3): 174-180.

Branco S, Rego C, Costa C, et al. Vitamin D Deficiency in Children and Adolescents with Type 1 Diabetes. Pediatric Diabetes. 2012; 13: 91-92.

Magee L, Mughal Z, Ehtisham S, et al. The Relationship between Vitamin D and HbA1C in A Type 1 Diabetic Paediatric Population. Endocrine Abstracts. 2012; 28(1): P38.

Sesadri KG, Tamilselvan B, and Rajendran A. Role of Vitamin D in Diabetes. Journal of Endocrinology an Metabolism. 2011; 1(2): 47-56.

Downloads

Published

2018-08-27

Issue

Vol. 30 No. 2 (2018)

Section

Research Article

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).