Implementasi Penyesuaian Obat Diabetes pada Saat Puasa Ramadan dan Pengaruhnya Terhadap Nilai HbA1c

Rahmi Safyanty, Retnosari Andrajati, Sudibyo Supardi, Ratu Ayu Dewi Sartika

Abstrak


Penelitian ini bertujuan untuk mengevaluasi pengaruh penyesuaian obat diabetes pada saat puasa Ramadan berdasarkan rekomendasi dari International Diabetes Federation-Diabetes and Ramadan International Alliance (IDF-DAR) terhadap nilai HbA1c pasien diabetes melitus (DM) tipe-2. Penelitian dilakukan di salah satu rumah sakit di Jakarta, Indonesia dengan menggunakan desain studi cross-sectional yang melibatkan 80 orang pasien DM tipe-2 rawat jalan yang menjalankan puasa Ramadan tahun 2016. Sebanyak 60% pasien menggunakan obat antidiabetes oral (OAD) dengan kombinasi obat terbanyak biguanida + sulfonilurea (27,5%). Penyesuaian obat dilakukan di mana sebanyak 56,2% adalah sesuai dengan rekomendasi IDF-DAR. Hasil penelitian menunjukkan bahwa rata-rata nilai HbA1c mengalami penurunan tidak bermakna (p = 0,082) dari 8,75 ± 1,90 menjadi 8,63 ± 1,82 setelah penyesuaian obat. Terdapat perbedaan bermakna pada nilai HbA1c pasien yang menggunakan obat antara yang sesuai dengan yang tidak sesuai rekomendasi IDF-DAR (p = 0,030). Ketidaksesuaian penggunaan obat berdasarkan IDF-DAR menyebabkan nilai HbA1c tidak terkontrol 3,222 kali lebih besar dibandingkan kesesuaian penggunaan obat berdasarkan IDF-DAR. Variabel yang memberikan pengaruh paling besar terhadap nilai HbA1c adalah jenis obat (p = 0,006). Penyesuaian yang tidak tepat pada insulin dan kombinasi insulin-OAD dapat menyebabkan nilai HbA1c yang tidak terkontrol 5 kali lebih besar dibandingkan OAD.

Kata Kunci


penyesuaian obat; rekomendasi IDF-DAR; puasa Ramadan; diabetes melitus tipe-2; HbA1c

Teks Lengkap:

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Referensi


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DOI: https://doi.org/10.25077/jsfk.7.2.126-134.2020

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