EFEKTIVITAS TERAPI INSULIN TERHADAP PENGENDALIAN KADAR GLUKOSA DARAH PADA PASIEN DIABETES MELLITUS TIPE 2 RAWAT INAP DI RSUP Dr. SARDJITO YOGYAKARTA

HERLINA, Dr. Ika Puspitasari, M.Si., Apt ; dr. M. Robikhul Ikhsan, M. Kes., Sp.PD., KEMD

2018 | Tesis | MAGISTER FARMASI KLINIK

Pada pasien diabetes mellitus tipe 2 rawat inap dengan adanya komplikasi menyebabkan kadar glukosa darah yang tidak terkendali sehingga memerlukan insulin yang kerjanya cepat dan dosisnya dapat disesuaikan dengan hasil kadar glukosa darah. Penelitian ini bertujuan untuk mengetahui pola penggunaan insulin, efektivitas terapi insulin, dan faktor yang mempengaruhi terhadap pengendalian kadar glukosa darah pada pasien diabetes melitus tipe 2 di Instalasi Rawat Inap 1 di RSUP Dr. Sardjito Yogyakarta. Penelitian cross sectional prospektif periode Februari-Maret 2018 dengan melibatkan 40 pasien DM tipe 2 dewasa yang mendapatkan terapi insulin di Instalasi Rawat Inap 1 RSUP Dr. Sardjito Yogyakarta. Data yang diperoleh dianalisis secara deskriptif analitik. Hubungan antara variabel pengaruh terhadap kadar glukosa darah menggunakan uji Chi-square. Korelasi pengaruh dosis insulin terhadap kadar glukosa darah menggunakan regresi linier. Pada penelitian yang paling banyak terlibat perempuan (52,5 %) dengan rerata usia 56,4 ± 8,9. Sebanyak 85% pasien memiliki kadar glukosa darah puasa tidak tercapai. Sebanyak 90% pasien yang menggunakan insulin kadar glukosa darah puasa tidak tercapai. Jenis insulin yang banyak digunakan adalah rapid acting 42,5% dan premixed insulin 35%. Penggunaan kortikosteroid yang paling banyak dexametason 20 mg (55,6%). Hasil analisis didapatkan faktor yang signifikan mempengaruhi pengendalian kadar glukosa darah puasa yaitu lama menderita DM tipe 2 dan penggunaan kortikosteroid (p<0,05) dan terdapat pengaruh rerata dosis insulin terhadap pencapaian rerata glukosa darah puasa (r = 0,379).

In inpatients with tipe 2 diabetes mellitus with complications lead to uncontrollable blood glucose levels so that require relatively fast and precise blood sugar regulation, fast-acting insulin and adjustable doses with blood glucose levels. This study aims to determine the patterns of insulin use, the effectiveness of insulin therapy, and the factors that affect the control of blood glucose levels in patients with type 2 diabetes mellitus at inpatient installation 1 in RSUP Dr. Sardjito Yogyakarta. A prospective cross sectional study period from February to March 2018 of 40 patients with type 2 diabetes mellitus who received insulin therapy at inpatient installation 1 in RSUP Dr. Sardjito, Yogyakarta. The data were obtained and analyzed descriptively analytic. The relationship between independent variable towards blood sugar level by using Chi-square test. The correlation of the effect of insulin dose to blood glucose level using linear regression test. The most involved in the research patients is female (52,5%) with mean age 56,4. As many as 85% of patients have fasting blood glucose levels were not achieved. As many as 90% of patients who used insulin fasting blood glucose levels were not achieved. Type of insulin mostly used is rapid acting 42,5% and premixed insulin 35%. The use of corticosteroids with the most dexamethasone 20 mg (55,6%). The analysis results showed that there are significant factors affecting the control of fasting blood glucose level. Those are long-suffering type 2 diabetes mellitus and corticosteroid use (p <0,05) and an effect of mean insulin dose to the achievement of the mean fasting blood glucose (r = 0,379).

Kata Kunci : DM tipe 2, efektivitas, insulin, glukosa darah puasa