ABSTRACT
Background: There are only few studies about diabetes in rural area in Indonesia. Epidemiological study are needed to formulate health policy of disease management in specific area. The aim of this study was to find the prevalence of diabetes and knowledge of diabetes among the community in Nangapanda Village, Ende District, East Nusa Tenggara. Methods: A cross-sectional study “Ende Diabetes Study” was conducted in Nangapanda Village. This study use cluster random sampling method to a total number of 19756 residents in Nangapanda village. From the sampling frame of 1800 adult subjects who underwent screening with glucometer in 2008 and 2009, 125 subjects have been diagnosed as diabetes or impaired fasting glucose (IFG). All of the subjects who were diagnosed as diabetes or IFG from the previous screening and 218 subjects from control (normal subjects in the 2008 and 2009 screening) were included in the present study. Each subject underwent general anamnesis, nutritional interview, complete physical examinations, and laboratory test (blood and urine). The data were analyzed using SPSS 13.0. Ressult: There were 343 subjects in this study. The prevalence of diabetes in Nangapanda using blood glucose criteria (using fasting and post-glucose load values) was 2%; using post glucose load criteria, the prevalence of DM was 1.56%; while with HbA1c criteria, the prevalence was 2.83%. The prevalence of impaired glucose tolerance (IGT) was 2.2%, and IFG was 6.2%. A number of 71.1% Nangapanda residents have sufficient knowledge about diabetes. Conclusion: Prevalence of diabetes in Nangapanda (using fasting and post-glucose load criteria) was 2% and 1.56% (using post-glucose load values). As much as 71.1% of Nangapanda residents have sufficient knowledge about diabetes.
Subject(s)
Diabetes Mellitus , Case ReportsABSTRACT
Background: The aim of this case study is to compare the effectiveness between cyclophosphamide and mycophenolate mofetil to achieve remission of lupus nephritis in an evidence-based case report from meta-analyses. Methods: Method in this case study is evidence-based case report using meta-analyses. Clinical question used in this paper is; which immunosuppressant gives better result in achieving remission in lupus nephritis patient: cyclophosphamide or mycophenolate mofetil? To answer this question, we search the evidence from PubMed with the keywords: “lupus nephritis AND mycophenolate mofetil AND cyclophosphamide” with inclusion criteria of meta-analysis, written in English, and focused comparing cyclophosphamide and mycophenolate mofetil. Results: From the searching method, we found 11 articles which is relevant. One has been excluded since it written in Hebrew, 4 articles excluded since are not focus answering the clinical question. At the end, 6 studies were included to the critical appraisal step. Conclusion: Based on the evidences, mycophenolate mofetil is non-inferior to cyclophosphamide in achieving remission in lupus nephritis patients, but with the better safety profile. Patient in our case study get mycophenolate mofetil and shows better clinical condition towards remission as she are evaluated in the outpatient clinic.
Subject(s)
Lupus Nephritis , Meta-AnalysisABSTRACT
Background: Pre-diabetes is a state where glucose level higher than normal, but not satisfy the criteria for diabetes. This condition is very critical, so that if subject don’t do lifestyle modification and pharmacology therapy, they could fall to diabetes. This research objective is to describe the prevalence and predictors of pre-diabetes in Indonesia. Methods: A cross-sectional study was conducted by Metabolic Endocrinology Division, Department of Internal Medicine FMUI/RSCM and Jakarta Diabetes and Lipid Center using secondary data from National Health Survey 2007. Total respondents are 24417 subjects from 33 provinces in Indonesia. We analyze characteristics, correlation, predictors, and attributable risks for some predictors of pre-diabetes and diabetes. Results: Prevalence of pre-diabetes (based on impaired glucose tolerance data) in Indonesia is 10%. Predictors of pre-diabetes are male, old-age, high socio-economic status, low education level, hypertension, obesity, central obesity, and smoking. Priority for pre-diabetes and diabetes prevention in Indonesia directed to decrease blood pressure (Attributable Risk/AR 56.5%), reduce waist circumference (AR 47.3%), and stop smoking (AR 44.4%). Conclusion: Prevalence of pre-diabetes in Indonesia is high so that we need a prevention strategy for pre-diabetes and the development from pre-diabetes to diabetes. The implementation of those strategies is compiled in the Indonesian Diabetes Prevention Program.