Diabetes Melitus Sebagai Faktor Risiko Tuberkulosis

Diabetes melitus (DM) tidak hanya meningkatkan risiko tuberkulosis (TB) aktif tetapi juga memengaruhi hasil pengobatan. Beban penyakit TB, terutama di negara berkembang, tetap tinggi meskipun telah dilakukan berbagai upaya pencegahan. Diabetes melitus yang menyebabkan imunosupresi semakin diakui sebagai faktor risiko independen untuk TB. Diabetes melitus meningkatkan risiko berkembangnya TB dua hingga tiga kali lipat dan juga meningkatkan risiko kegagalan pengobatan TB, kekambuhan, dan kematian. Diabetes juga dapat menyebabkan penyakit parah, reaktivasi fokus TB yang tidak aktif, dan hasil pengobatan TB yang buruk. Beberapa obat antituberkulosis yang biasa digunakan secara terpisah dapat menyebabkan gangguan toleransi glukosa. Skrining tuberkulosis pada penderita diabetes dan skrining diabetes pada pasien tuberkulosis telah direkomendasikan. Hal ini perlu diterapkan mengingat efektivitas dan manfaatnya.Hubungan antara diabetes mellitus (DM) dan tuberkulosis (TB) adalah saling berkaitan,  karena DM tidak hanya meningkatkan risiko TB aktif tetapi juga mempengaruhi hasil pengobatan. Beban penyakit TB, terutama di negara berkembang, tetap tinggi meskipun telah dilakukan berbagai upaya pencegahan. Diabetes mellitus yang menyebabkan imunosupresi semakin diakui sebagai faktor risiko independen untuk TB. Diabetes mellitus meningkatkan risiko berkembangnya TB dua hingga tiga kali lipat dan juga meningkatkan risiko kegagalan pengobatan TB, kekambuhan, dan kematian. Diabetes juga dapat menyebabkan penyakit parah, reaktivasi fokus TB yang tidak aktif, dan hasil pengobatan TB yang buruk. Beberapa obat antituberkulosis yang biasa digunakan secara terpisah dapat menyebabkan gangguan toleransi glukosa. Skrining tuberkulosis pada penderita diabetes telah direkomendasikan, tetapi memerlukan bukti nyata mengingat efektivitas biaya dan manfaatnya. Kata Kunci: diabetes mellitus, hubungan kausal, tuberkulosi

Vaspin in Developing Obesity (Vande-Ob); the Correlation of Waist Circumference and Visceral Fat Percentage with Vaspin Levels in Patients with Type II Diabetes Mellitus

BACKGROUND: Vaspin concentration was thought to be associated with obesity, impaired insulin sensitivity, and fitness level. The correlation of vaspin and leptin supports the theory of vaspin associated with body fat mass. AIM: To determine the correlation between visceral fat distributions and serum vaspin level in type II DM patients. METHODS: We conduct an observational, analytical cross-sectional study. Sixty subjects with type II diabetes mellitus who came to Diabetes Center of Sanglah General Hospital were included consecutively. Each subject has to sign an informed consent before physical and laboratory examination took place. Spearman correlation test was used to analyse the correlation between waist circumference and visceral fat percentage with serum vaspin level since the data were not distributed normally. RESULTS: Mean laboratory results in all subjects of vaspin levels was 2.389 ± 3.586 ng/ml, mean waist circumference was 94.95 ± 11.78 cm and mean visceral fat percentage was 18.05 ± 23.63%. We found we found no significant correlation between between vaspin with waist circumference (r = -0.044; p = 0.738) and visceral fat percentage (r = -0.103; p = 0.435). CONCLUSIONS: The vaspin level did not significantly correlate with waist circumference and visceral fat percentage in type II diabetes patients

Vitamin D Deficiency as a Factor Associated with Cognitive Impairment in Patients with Type 2 Diabetes Mellitus

Objective: Vitamin D as an essential nutrient is increasingly being studied and reported to have roles in diabetes and cognitive function through its antioxidant, anti-inflammatory, and neuroprotective functions. This study aimed to investigate vitamin D deficiency as a factor associated with cognitive impairment in Type 2 Diabetes Mellitus patients. Materials and Methods: This case-control study was conducted at the diabetic center and neurology outpatient clinic at Prof. Dr. I.G.N.G Ngoerah Hospital in Denpasar, Indonesia between September and December 2022. Cases had a score of < 26 on the Montreal Cognitive Assessment questionnaire (Indonesian version) controls had a score ≥26. Vitamin D levels were assessed using serum 25-hydroxyvitamin D levels. The cut-off for vitamin D deficiency was obtained through the receiver operating curve characteristic. Results: In total 31 cases and 31 controls were included. The cut-off for vitamin D deficiency was <24.6 ng/ml. Patients with T2DM and vitamin D deficiency had an increased association with cognitive impairment (OR 3.8; 95% CI [1.1 to 13.4]) compared to patients without vitamin D deficiency. Other independent factors associated with cognitive impairment in T2DM were low education levels (OR 5.4; 95% CI [1.3 to 22.2]) and diabetes duration of more than 5 years (OR 4.1; 95% CI [1.1 to 14.4]). Conclusion: Vitamin D deficiency is one of the factors associated with cognitive impairment in T2DM patients

Fasting Gastric Acidity Evidential Effect on Esophageal Mucosal Damage

Gastric substances that potentially increase the esophageal mucosal damage are: gastric acid, pepsin, bile salts, and pancreatic enzymes. From all of these substances, the highest potential for reflux damage is gastric acid. Although the main cause of clinical symptoms of GERD is acid reflux, it has been known that there are subgroups with typical reflux symptoms that do not provide sufficient response or not responsive to PPI treatment. Despite the improvement of esophagitis, there is no clinical improvements in reflux symptoms of 30% respondents. Therefore, this study was designed to determine fasting gastric acidity with endoscopic findings in patients with GERD. A comparative-analysis study, which determine the fasting gastric acidity from endoscopic findings in patients with GERD. Samples recruited using consecutives sampling technique and divided into groups of esophagitis and non-esophagitis reflux. A total of 40 samples involved in this study. The Mann-Whitney test, was used for analyzing the difference between fasting gastric acidity from endoscopic findings of esophagitis lesions in patient with GERD. The median value for fasting gastric acidity in the esophagitis reflux group was 1.88 (0.82-4.84), whereas the median value for fasting gastric acidity in the non-esophagitis reflux group was 2.49 (0.68-5.97). The Mann-Whitney test result was p=0.298 (p&gt;0.05). This study shows that there is no significant difference of fasting gastric acidity from endoscopic findings between esophagitis and non esophagitis reflux groups in patients with gastroesophageal reflux disease (GERD). This study shows that esophagitis lesions are not affected by gastric acidity

Effect of Vitamin D Supplementation in Disease Activity, Activity-Related Markers, Inflammatory Marker and Serum Calcium of Systemic Lupus Erythematosus Patiens: A Systematic Review and Meta-Analysis

Background: Effect of additional supplementation of vitamin D toward Systemic lupus erythematosus (SLE) disease activity still differ in results obtained between studies being conducted. The current meta-analysis systematically analyzed the effect of vitamin D supplementation on SLE disease activity with updated literature, also its effect toward other parameters. Material and Methods: Relevant literatures were obtained from PubMed database and Google Scholar. The obtained studies were analyzed using fixed effect model or random effect model. Results: Five eligible studies with a total of 318 participants were included. Vitamin D supplementation did not affect the total SLEDAI score in SLE patients with pooled mean difference of -0.96 (p =0.09; 95% CI: -2.06 to 0.14). Serum vitamin D level increased after administration of vitamin D with pooled mean difference of 12.67 (p =0.001; 95% CI: 5.04 to 20.29). vitamin D supplementation increase serum calcium levels, with pooled difference of 0.07 (p = 0.006; 95% CI: 0.02 to 0.12). Pooled results from two studies obtained vitamin D supplementation did not affect ESR, C3 and C4. Conclusions: Current meta-analysis obtained no significant changes in SLEDAI scores due to vitamin D supplementation. In contrast, serum vitamin D and serum calcium levels were increased